Provider Demographics
NPI:1124226741
Name:MAKINTUBEE, SUSANA (BA, CM)
Entity Type:Individual
Prefix:
First Name:SUSANA
Middle Name:
Last Name:MAKINTUBEE
Suffix:
Gender:F
Credentials:BA, CM
Other - Prefix:
Other - First Name:SUSANA
Other - Middle Name:
Other - Last Name:PEREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA, CM
Mailing Address - Street 1:2577 LYNN LN
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-1762
Mailing Address - Country:US
Mailing Address - Phone:405-922-5498
Mailing Address - Fax:
Practice Address - Street 1:1025 STRAKA TER
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-2544
Practice Address - Country:US
Practice Address - Phone:405-632-6688
Practice Address - Fax:405-602-5621
Is Sole Proprietor?:No
Enumeration Date:2007-07-05
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)