Provider Demographics
NPI:1003593757
Name:GIROUX, CLARISSA K
Entity Type:Individual
Prefix:
First Name:CLARISSA
Middle Name:K
Last Name:GIROUX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8242 S HARVARD AVE STE A
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-1648
Mailing Address - Country:US
Mailing Address - Phone:918-553-0881
Mailing Address - Fax:
Practice Address - Street 1:8242 S HARVARD AVE STE A
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-1648
Practice Address - Country:US
Practice Address - Phone:918-553-0881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician