Provider Demographics
NPI:1023534484
Name:MAHONEY, LUCIA CECILIA (X-RAY TECH, ADM,)
Entity Type:Individual
Prefix:
First Name:LUCIA
Middle Name:CECILIA
Last Name:MAHONEY
Suffix:
Gender:F
Credentials:X-RAY TECH, ADM,
Other - Prefix:
Other - First Name:LUCY
Other - Middle Name:C
Other - Last Name:MAHONEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:222 E EUFAULA ST STE 220
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-6080
Mailing Address - Country:US
Mailing Address - Phone:405-310-2756
Mailing Address - Fax:405-310-2753
Practice Address - Street 1:222 E EUFAULA ST STE 220
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-6080
Practice Address - Country:US
Practice Address - Phone:405-310-2756
Practice Address - Fax:405-310-2753
Is Sole Proprietor?:No
Enumeration Date:2017-08-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKHC7883374U00000X, 376K00000X, 372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No374U00000XNursing Service Related ProvidersHome Health Aide
No376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKHC7883OtherHOME CARE