MEDICARE: LOIS K. TROST M.S.W.

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	1041C0700X	Clinical Social Worker	#3146	OK

General Provider Information

NPI Number	:	1558497248
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOIS K. TROST M.S.W.

Provider Business Mailing Address
First Line	:	6846 S CANTON AVE
Second Line	:	SUITE 501
City	:	TULSA
State	:	OK
Zip	:	74136-3412
Country	:	US
Telephone Number	:	918-745-0095
Fax Number	:	918-745-0190

Provider Business Practice Location Address
First Line	:	6846 S CANTON AVE
Second Line	:	SUITE 501
City	:	TULSA
State	:	OK
Zip	:	74136-3412
Country	:	US
Telephone Number	:	918-745-0095
Fax Number	:	918-745-0190

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

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	05/10/2011

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