MEDICARE: MRS. LORI ANN COLBART

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
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1548639875
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LORI ANN COLBART

Provider Business Mailing Address
First Line	:	3113 SW 82ND ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73159-4428
Country	:	US
Telephone Number	:	405-818-5827
Fax Number	:

Provider Business Practice Location Address
First Line	:	3113 SW 82ND ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73159-4428
Country	:	US
Telephone Number	:	405-818-5827
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2015
Last Update Date	:	03/17/2021

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