Doctor Name: | ELIZABETH ANN EDEN |
NPI Number: | 1164695292 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSSW |
License Number: | |
Business Practice Address: | 23 East Ross Street Sapulpa, OK - 74066 |
Business Phone Number: | 9182272016 |
Business Fax Number: | 9182271125 |
Mailing Address: | 114 N Grand Ave, Ste # 418 OKMULGEE |
State: | OK |
Postal Code: | 744474013 |
Phone Number: | 9187562303 |
Fax Number: | 9187562126 |
NPI Enumeration Date: | 04/09/2008 |
NPI Last Update Date: | 04/14/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |