Chabli Glaze

Individual provider Active NPI Case Management Agency · Spencer, OK

NPI 1003160482 · NPPES record last updated Jan 19, 2013

Key facts

NPI
1003160482
Entity type
Individual (NPI type 1)
Primary specialty
Case Management Agency 251B00000X
Practice address
8905 NE 51St St
Spencer, OK 73084-1420
Phone
(405) 408-9989
NPI assigned
Nov 6, 2012
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X OK Yes

Addresses

Primary practice location

8905 NE 51St St
Spencer, OK 73084-1420

Mailing address

8905 NE 51St St
Spencer, OK 73084-1420
Phone (405) 408-9989

Other names

  • Chabli Glaze Other name

Other providers in Spencer, OK

All providers in Spencer, OK · Case Management Agency in Oklahoma

Sources for this page

Verify at the official NPI Registry.