Provider Demographics
NPI:1386037349
Name:PATRICK, MICHELLE
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:PATRICK
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 1:2525 NW EXPRESSWAY SUITE 531
Mailing Address - Street 2:BUILDING UP PEOPLE BEHAVIORAL HEALTH SERIVES
Mailing Address - City:OKLAHOMA
Mailing Address - State:OK
Mailing Address - Zip Code:73111
Mailing Address - Country:US
Mailing Address - Phone:405-242-5031
Mailing Address - Fax:405-286-9671
Practice Address - Street 1:2525 NW EXPRESSWAY SUITE 531
Practice Address - Street 2:BUILDING UP PEOPLE BEHAVIORAL HEALTH SERVICE
Practice Address - City:OKLAHOMA
Practice Address - State:OK
Practice Address - Zip Code:73111
Practice Address - Country:US
Practice Address - Phone:405-242-5031
Practice Address - Fax:405-286-9617
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-13
Last Update Date:2015-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health