1083663959 NPI number — MRS. NIANI Y CHRISTIAN-WARE LPC

Table of content: MRS. NIANI Y CHRISTIAN-WARE LPC (NPI 1083663959)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083663959 NPI number — MRS. NIANI Y CHRISTIAN-WARE LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHRISTIAN-WARE
Provider First Name:
NIANI
Provider Middle Name:
Y
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WARE
Provider Other First Name:
NIANI
Provider Other Middle Name:
Y
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1083663959
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11718 N 118TH EAST AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLLINSVILLE
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
74021-1004
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
918-371-9538
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5525 E 51ST ST
Provider Second Line Business Practice Location Address:
SUITE #400
Provider Business Practice Location Address City Name:
TULSA
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74135-7461
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
918-388-6239
Provider Business Practice Location Address Fax Number:
918-388-6456
Provider Enumeration Date:
05/09/2006

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: 101YM0800X , with the licence number:  3627 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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