1790812303 NPI number — MRS. GLORIA J. SCHRATWIESER LPC

Table of content: MRS. GLORIA J. SCHRATWIESER LPC (NPI 1790812303)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790812303 NPI number — MRS. GLORIA J. SCHRATWIESER LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHRATWIESER
Provider First Name:
GLORIA
Provider Middle Name:
J.
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:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1790812303
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/11/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1132 S DOUGLAS BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MIDWEST CITY
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73130-5236
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
405-737-1132
Provider Business Mailing Address Fax Number:
405-737-1112

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2912 S DOUGLAS BLVD STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIDWEST CITY
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73130-7179
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-737-1132
Provider Business Practice Location Address Fax Number:
405-737-1112
Provider Enumeration Date:
02/28/2007

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: 101YP2500X , with the licence number:  3632 , 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)





Copyright © 2007-2025 www.npivalidator.com