Provider Demographics
NPI:1013223544
Name:COLBERT, CLARESE RASHA
Entity Type:Individual
Prefix:
First Name:CLARESE
Middle Name:RASHA
Last Name:COLBERT
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 1:621 NW 113TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73114-6810
Mailing Address - Country:US
Mailing Address - Phone:405-255-9201
Mailing Address - Fax:
Practice Address - Street 1:621 NW 113TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73114-6810
Practice Address - Country:US
Practice Address - Phone:405-255-9201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-21
Last Update Date:2010-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor