Provider Demographics
NPI:1063851566
Name:SIGALA, V ICENTE CEREACO (BHRS)
Entity Type:Individual
Prefix:MR
First Name:V ICENTE
Middle Name:CEREACO
Last Name:SIGALA
Suffix:
Gender:M
Credentials:BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5714 S WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73109-4515
Mailing Address - Country:US
Mailing Address - Phone:405-601-1154
Mailing Address - Fax:405-601-1183
Practice Address - Street 1:5714 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73109-4515
Practice Address - Country:US
Practice Address - Phone:405-601-1154
Practice Address - Fax:405-601-1183
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-18
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor