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NPI Code Detail

MEDICARE: RACHAEL ELIZABETH ELAM BSSW

MEDICARE: RACHAEL ELIZABETH ELAM BSSW
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1639305725
Entity Type Code : Individual
Provider Name (Legal Business Name) : RACHAEL ELIZABETH ELAM BSSW
Provider Business Mailing Address
First Line : 650 S PEORIA AVE
Second Line :
City : TULSA
State : OK
Zip : 74120-4429
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 102 N DENVER AVE
Second Line :
City : TULSA
State : OK
Zip : 74103-1806
Country : US
Telephone Number : 918-582-1200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/03/2009
Last Update Date : 06/03/2009

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