Provider Demographics
NPI:1558536458
Name:MAKWANGWALA, ISABEL
Entity Type:Individual
Prefix:
First Name:ISABEL
Middle Name:
Last Name:MAKWANGWALA
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 1:1222 10TH STREET, SUITE 211
Mailing Address - Street 2:NORTHWEST CENTER FOR BEHAVIORAL HEALTH
Mailing Address - City:WOODWARD
Mailing Address - State:OK
Mailing Address - Zip Code:73801
Mailing Address - Country:US
Mailing Address - Phone:580-338-5851
Mailing Address - Fax:580-338-6022
Practice Address - Street 1:5120 HWY 54 NE
Practice Address - Street 2:NORTHWEST CENTER FOR BEHAVIORAL HEALTH
Practice Address - City:GUYMON
Practice Address - State:OK
Practice Address - Zip Code:73942
Practice Address - Country:US
Practice Address - Phone:580-338-5851
Practice Address - Fax:580-338-6022
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health