Amber R Black

Individual provider Active NPI Counselor · Choctaw, OK

NPI 1700222015 · NPPES record last updated May 14, 2013

Key facts

NPI
1700222015
Entity type
Individual (NPI type 1)
Primary specialty
Counselor 101Y00000X
Practice address
14700 SE 27TH CT
Choctaw, OK 73020-6596
Phone
(405) 613-8848
NPI assigned
May 14, 2013
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
Counselor 101Y00000X Yes

Addresses

Primary practice location

14700 SE 27TH CT
Choctaw, OK 73020-6596

Mailing address

14700 SE 27TH CT
Choctaw, OK 73020-6596
Phone (405) 613-8848

Other names

  • Amber R Vahabzadegan Former name

Other providers in Choctaw, OK

All providers in Choctaw, OK · Counselor in Oklahoma

Sources for this page

Verify at the official NPI Registry.