Provider Demographics
NPI:1518215581
Name:HARTFIELD, MARY
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:
Last Name:HARTFIELD
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 1:5101 NW 220TH ST
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73025-9156
Mailing Address - Country:US
Mailing Address - Phone:405-365-4161
Mailing Address - Fax:
Practice Address - Street 1:5101 NW 220TH ST
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73025-9156
Practice Address - Country:US
Practice Address - Phone:405-365-4161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-24
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst