Provider Demographics
NPI:1285040089
Name:ISAACS, DEVON SUE
Entity Type:Individual
Prefix:MRS
First Name:DEVON
Middle Name:SUE
Last Name:ISAACS
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 1:318 W CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:STILWELL
Mailing Address - State:OK
Mailing Address - Zip Code:74960-4224
Mailing Address - Country:US
Mailing Address - Phone:918-575-4523
Mailing Address - Fax:
Practice Address - Street 1:614 W OLIVE ST
Practice Address - Street 2:
Practice Address - City:STILWELL
Practice Address - State:OK
Practice Address - Zip Code:74960-2839
Practice Address - Country:US
Practice Address - Phone:918-696-2181
Practice Address - Fax:918-696-2182
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-01
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional