Provider Demographics
NPI:1497851034
Name:COE, ALICE ANN (MS, LPC)
Entity Type:Individual
Prefix:MRS
First Name:ALICE
Middle Name:ANN
Last Name:COE
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4832 S 162ND EAST AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74134-5000
Mailing Address - Country:US
Mailing Address - Phone:918-693-5045
Mailing Address - Fax:
Practice Address - Street 1:130 N GREENWOOD AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74120-1443
Practice Address - Country:US
Practice Address - Phone:918-599-7277
Practice Address - Fax:918-599-7716
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2733101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional