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NPI Code Detail

MEDICARE: MS. ELIZABETH MARY AVANT MA

MEDICARE: MS. ELIZABETH MARY AVANT MA
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1659601243
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ELIZABETH MARY AVANT MA
Provider Business Mailing Address
First Line : 9225 LAKE HEFNER PKWY
Second Line : SUITE 101
City : OKLAHOMA CITY
State : OK
Zip : 73120-2061
Country : US
Telephone Number : 405-754-0144
Fax Number :
Provider Business Practice Location Address
First Line : 9225 LAKE HEFNER PKWY
Second Line : SUITE 101
City : OKLAHOMA CITY
State : OK
Zip : 73120-2061
Country : US
Telephone Number : 405-754-0144
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2010
Last Update Date : 08/21/2014

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