MEDICARE: MARY BETH RITCHIE L.C.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	1876	OK

General Provider Information

NPI Number	:	1740799279
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY BETH RITCHIE L.C.S.W.

Provider Business Mailing Address
First Line	:	6010 S ATLANTA PL
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74105-7521
Country	:	US
Telephone Number	:	918-749-7822
Fax Number	:

Provider Business Practice Location Address
First Line	:	6010 S ATLANTA PL
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74105-7521
Country	:	US
Telephone Number	:	918-749-7822
Fax Number	:

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

Provider Enumeration Date	:	09/27/2017
Last Update Date	:	07/21/2022

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