MEDICARE: PATRICIA CHAVEZ-ANAYA MHR 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
1	101YP2500X	Professional Counselor	4322	OK

General Provider Information

NPI Number	:	1841566569
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA CHAVEZ-ANAYA MHR LPC

Provider Business Mailing Address
First Line	:	11208 SW 37TH CT
Second Line	:
City	:	MUSTANG
State	:	OK
Zip	:	73064-9209
Country	:	US
Telephone Number	:	405-317-6613
Fax Number	:

Provider Business Practice Location Address
First Line	:	5909 NW EXPRESSWAY
Second Line	:	SUITE 530
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73132-5161
Country	:	US
Telephone Number	:	405-470-8778
Fax Number	:

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

Provider Enumeration Date	:	03/27/2012
Last Update Date	:	10/08/2013

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