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NPI Code Detail

MEDICARE: MIA ANDERSON LPC

MEDICARE:   MIA  ANDERSON  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 Counselor

General Provider Information

NPI Number : 1962806513
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIA ANDERSON LPC
Provider Business Mailing Address
First Line : 309 S ANN ARBOR AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73128-1112
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 309 S ANN ARBOR AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73128-1112
Country : US
Telephone Number : 405-948-4900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/10/2014
Last Update Date : 08/01/2025

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Directions to “ MIA ANDERSON LPC” Practice Location

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