MEDICARE: MRS. ASYA I AL-ALEEM

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

General Provider Information

NPI Number	:	1962745158
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ASYA I AL-ALEEM

Provider Business Mailing Address
First Line	:	PO BOX 21134
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73156-1134
Country	:	US
Telephone Number	:	405-602-8046
Fax Number	:

Provider Business Practice Location Address
First Line	:	1320 NE 47TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73111-5816
Country	:	US
Telephone Number	:	405-602-8046
Fax Number	:

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

Provider Enumeration Date	:	04/05/2013
Last Update Date	:	04/05/2013

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