MEDICARE: COLLETTE TEMPLETON

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1841603115
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COLLETTE TEMPLETON

Provider Business Mailing Address
First Line	:	6004 YALE DR
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73162-7529
Country	:	US
Telephone Number	:	405-532-6445
Fax Number	:

Provider Business Practice Location Address
First Line	:	6004 YALE DR
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73162-7529
Country	:	US
Telephone Number	:	405-532-6445
Fax Number	:

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

Provider Enumeration Date	:	06/04/2014
Last Update Date	:	06/04/2014

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Directions to “ COLLETTE TEMPLETON ” Practice Location

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