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NPI Code Detail

MEDICARE: MISS ANN MARIE ALLEN LADC INTENT

MEDICARE:  MISS ANN MARIE ALLEN  LADC INTENT
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
1101YA0400XAddiction (Substance Use Disorder) CounselorOK

Other Identifiers

General Provider Information

NPI Number : 1699806877
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS ANN MARIE ALLEN LADC INTENT
Provider Business Mailing Address
First Line : 12120 BLUEWAY AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73162-1068
Country : US
Telephone Number : 405-246-6991
Fax Number :
Provider Business Practice Location Address
First Line : 2701 N OKLAHOMA AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73105-2724
Country : US
Telephone Number : 405-528-8686
Fax Number : 405-528-8692
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2007
Last Update Date : 07/05/2013

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Directions to “ MISS ANN MARIE ALLEN LADC INTENT” Practice Location

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