Doctor Name: | MARY P ANDERSON |
NPI Number: | 1235167057 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSW |
License Number: | 1389 |
Business Practice Address: | 10917 N 92nd East Ave Owasso, OK - 740556541 |
Business Phone Number: | 9186079677 |
Business Fax Number: | 8777772249 |
Mailing Address: | 10917 N 92nd East Ave, OWASSO |
State: | OK |
Postal Code: | 740556541 |
Phone Number: | 9186079677 |
Fax Number: | 8777772249 |
NPI Enumeration Date: | 06/29/2006 |
NPI Last Update Date: | 05/27/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 1389 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |