Provider Demographics
NPI:1114237203
Name:HARRIGAN, SUSAN DIANE
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:DIANE
Last Name:HARRIGAN
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 1:5228 CLASSEN CIR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118-4429
Mailing Address - Country:US
Mailing Address - Phone:405-840-9000
Mailing Address - Fax:405-840-9017
Practice Address - Street 1:5228 CLASSEN CIR
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-4429
Practice Address - Country:US
Practice Address - Phone:405-840-9000
Practice Address - Fax:405-840-9017
Is Sole Proprietor?:No
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor