Provider Demographics
NPI:1063659068
Name:SPILMAN, LEALYN S
Entity Type:Individual
Prefix:MS
First Name:LEALYN
Middle Name:S
Last Name:SPILMAN
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 1:723 N BIRMINGHAM AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74110-5313
Mailing Address - Country:US
Mailing Address - Phone:918-855-7537
Mailing Address - Fax:
Practice Address - Street 1:723 N BIRMINGHAM AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74110-5313
Practice Address - Country:US
Practice Address - Phone:918-855-7537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-13
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)