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NPI Code Detail

MEDICARE: S. ZHANA BOSA RISLEY LPC

MEDICARE:   S. ZHANA BOSA RISLEY  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
1101YM0800XMental Health Counselor1916OK

General Provider Information

NPI Number : 1881798395
Entity Type Code : Individual
Provider Name (Legal Business Name) : S. ZHANA BOSA RISLEY LPC
Provider Business Mailing Address
First Line : 6004 NW 16TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73127-2604
Country : US
Telephone Number : 405-760-6060
Fax Number :
Provider Business Practice Location Address
First Line : 2401 NW 23RD ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73107-2442
Country : US
Telephone Number : 405-522-8185
Fax Number : 405-522-8187
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2006
Last Update Date : 07/08/2007

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Directions to “ S. ZHANA BOSA RISLEY LPC” Practice Location

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