1467605113 NPI number — OLA SUSAN HUFFMASTER OKROGLIC LMSW

Table of content: OLA SUSAN HUFFMASTER OKROGLIC LMSW (NPI 1467605113)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467605113 NPI number — OLA SUSAN HUFFMASTER OKROGLIC LMSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HUFFMASTER OKROGLIC
Provider First Name:
OLA SUSAN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HUFFMASTER
Provider Other First Name:
OLA
Provider Other Middle Name:
SUSAN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1467605113
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/28/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 679
Provider Second Line Business Mailing Address:
100 S. CHEROKEE
Provider Business Mailing Address City Name:
MORRILTON
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72110-0679
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
501-354-4589
Provider Business Mailing Address Fax Number:
501-354-5410

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
730 BOSTON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DANVILLE
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72833
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
479-495-5177
Provider Business Practice Location Address Fax Number:
479-495-5187
Provider Enumeration Date:
10/28/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X , with the licence number:  2231M , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1041C0700X , with the licence number: 2231-M , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)