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NPI Code Detail

MEDICARE: SUZANNE ALAIN WATERS

MEDICARE:   SUZANNE ALAIN WATERS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker20042OK

General Provider Information

NPI Number : 1467919258
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUZANNE ALAIN WATERS
Provider Business Mailing Address
First Line : 12312 S LAND AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73170-4514
Country : US
Telephone Number : 405-252-0515
Fax Number :
Provider Business Practice Location Address
First Line : 8524 S WESTERN AVE STE 115
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73139-9248
Country : US
Telephone Number : 405-252-0515
Fax Number : 405-698-2776
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2019
Last Update Date : 03/22/2026

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Directions to “ SUZANNE ALAIN WATERS ” Practice Location

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