Provider Demographics
NPI:1215184536
Name:SAMARA, ELIZABETH DEE (MA)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:DEE
Last Name:SAMARA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2932 NW 122ND ST
Mailing Address - Street 2:SUITE 10
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-1957
Mailing Address - Country:US
Mailing Address - Phone:405-250-2140
Mailing Address - Fax:405-242-5345
Practice Address - Street 1:2932 NW 122ND ST
Practice Address - Street 2:SUITE 10
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-1957
Practice Address - Country:US
Practice Address - Phone:405-250-2140
Practice Address - Fax:405-242-5345
Is Sole Proprietor?:No
Enumeration Date:2008-08-19
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor