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NPI Code Detail

MEDICARE: SANDRA LOUISE OLIVER LCSW

MEDICARE: SANDRA LOUISE OLIVER LCSW
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
11041C0700XClinical Social Worker3702OK

General Provider Information

NPI Number : 1992026009
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANDRA LOUISE OLIVER LCSW
Provider Business Mailing Address
First Line : PO BOX 12490
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73157-2490
Country : US
Telephone Number : 405-641-4138
Fax Number :
Provider Business Practice Location Address
First Line : 9700 S PENNSYLVANIA AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73159-6917
Country : US
Telephone Number : 405-641-4138
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2010
Last Update Date : 12/20/2013

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Directions to “ SANDRA LOUISE OLIVER LCSW” Practice Location

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