Maria Lara
Individual provider Active NPI Counselor · Mangum, OK
NPI 1033933593 · NPPES record last updated Nov 12, 2024
Key facts
- NPI
- 1033933593
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 1916 N Louis Tittle Ave
Mangum, OK 73554-1629 - Phone
- (405) 402-5218
- NPI assigned
- Nov 12, 2024
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
1916 N Louis Tittle Ave
Mangum, OK 73554-1629
Mailing address
1916 N Louis Tittle Ave
Mangum, OK 73554-1629
Phone (405) 402-5218
Other providers in Mangum, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 12, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.