Provider Demographics
NPI:1477809713
Name:SAMUEL, BETSY E (MSW)
Entity Type:Individual
Prefix:
First Name:BETSY
Middle Name:E
Last Name:SAMUEL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13224 CEDAR TRL
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73131-1832
Mailing Address - Country:US
Mailing Address - Phone:405-474-4374
Mailing Address - Fax:405-341-0185
Practice Address - Street 1:330 W GRAY ST
Practice Address - Street 2:SUITE 140
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-7129
Practice Address - Country:US
Practice Address - Phone:405-919-6821
Practice Address - Fax:405-360-1616
Is Sole Proprietor?:No
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical