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NPI Code Detail

MEDICARE: MRS. MEEYOUN IN PAVLICEK LPC

MEDICARE: MRS. MEEYOUN IN PAVLICEK LPC
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
1101YP2500XProfessional Counselor1569OK

General Provider Information

NPI Number : 1699817155
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MEEYOUN IN PAVLICEK LPC
Provider Business Mailing Address
First Line : 650 S PEORIA
Second Line :
City : TULSA
State : OK
Zip : 74120-4429
Country : US
Telephone Number : 918-587-9471
Fax Number : 918-560-0137
Provider Business Practice Location Address
First Line : 102 N DENVER
Second Line :
City : TULSA
State : OK
Zip : 74103-1820
Country : US
Telephone Number : 918-582-1200
Fax Number : 918-581-0777
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2007
Last Update Date : 07/08/2007

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