Doctor Name: | MS. MARIETTA PAULETTE SOUSIS |
NPI Number: | 1043423817 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | R.N. |
License Number: | 78960 |
Business Practice Address: | 2322 W 7th Ave Stillwater, OK - 740741903 |
Business Phone Number: | 4053721131 |
Business Fax Number: | 4053723632 |
Mailing Address: | 4436 Nw 50th St, OKLAHOMA CITY |
State: | OK |
Postal Code: | 731122212 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 05/08/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WP0808X |
License Number: | 78960 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Psych/Mental Health |
Taxonomy Definition: |