Myrtle L Collins
Individual provider Active NPI Counselor · Wagoner, OK
NPI 1174774913 · NPPES record last updated Oct 9, 2008
Key facts
- NPI
- 1174774913
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 32175 E 723 Rd
Wagoner, OK 74467-7425 - Phone
- (918) 485-1552
- NPI assigned
- Oct 9, 2008
- 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
32175 E 723 Rd
Wagoner, OK 74467-7425
Mailing address
32175 E 723 Rd
Wagoner, OK 74467-7425
Phone (918) 485-1552
Other providers in Wagoner, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 9, 2008. 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.