Provider Demographics
NPI:1396181327
Name:LABAT, SUSETTE MARIE
Entity Type:Individual
Prefix:
First Name:SUSETTE
Middle Name:MARIE
Last Name:LABAT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SUE
Other - Middle Name:
Other - Last Name:LABAT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2601 N TROSPER DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73141-3839
Mailing Address - Country:US
Mailing Address - Phone:918-752-8887
Mailing Address - Fax:
Practice Address - Street 1:2601 N TROSPER DR
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73141-3839
Practice Address - Country:US
Practice Address - Phone:918-752-8887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-16
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program