Provider Demographics
NPI:1376883629
Name:NEWNAM, ANJE
Entity Type:Individual
Prefix:
First Name:ANJE
Middle Name:
Last Name:NEWNAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANJE
Other - Middle Name:
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1433 DEER CHASE DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-3934
Mailing Address - Country:US
Mailing Address - Phone:405-238-0216
Mailing Address - Fax:
Practice Address - Street 1:8753 S COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-2513
Practice Address - Country:US
Practice Address - Phone:405-238-0216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-25
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor
No251S00000XAgenciesCommunity/Behavioral Health