Provider Demographics
NPI:1326357419
Name:KNOWLES, HEATHER R
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:R
Last Name:KNOWLES
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 1:3021 N ROBINSON AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73103-4124
Mailing Address - Country:US
Mailing Address - Phone:214-662-4556
Mailing Address - Fax:405-293-9047
Practice Address - Street 1:2905 S HARR DR STE 102
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-3049
Practice Address - Country:US
Practice Address - Phone:405-818-8364
Practice Address - Fax:405-293-9047
Is Sole Proprietor?:No
Enumeration Date:2010-10-06
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor