Provider Demographics
NPI:1235420407
Name:ADAMS, MAUREEN OTIS (BA, CBHCM)
Entity Type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:OTIS
Last Name:ADAMS
Suffix:
Gender:F
Credentials:BA, CBHCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3507 E ADMIRAL PL
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74115-8211
Mailing Address - Country:US
Mailing Address - Phone:918-934-4194
Mailing Address - Fax:918-834-4189
Practice Address - Street 1:3507 E ADMIRAL PL
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74115-8211
Practice Address - Country:US
Practice Address - Phone:918-934-4194
Practice Address - Fax:918-834-4189
Is Sole Proprietor?:No
Enumeration Date:2011-04-22
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker