Provider Demographics
NPI:1497046163
Name:HOWARD, SANDRA LOUISE
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:LOUISE
Last Name:HOWARD
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 1:5110 S YALE AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-7438
Mailing Address - Country:US
Mailing Address - Phone:918-779-7637
Mailing Address - Fax:918-938-6037
Practice Address - Street 1:7010 S YALE AVE
Practice Address - Street 2:SUITE 215
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-5705
Practice Address - Country:US
Practice Address - Phone:918-492-2554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-28
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator