Individual
MISS AMANDA MARIE MARCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2701 N OKLAHOMA AVE, OKLAHOMA CITY, OK 73105-2724
(405) 528-8686
(405) 528-8692
Mailing address
2701 N OKLAHOMA AVE, OKLAHOMA CITY, OK 73105-2724
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100742400B
—
OK
05
—
100742400D
—
OK
05
—
100742400F
—
OK
Enumeration date
06/28/2008
Last updated
06/28/2008
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