Provider Demographics
NPI:1609138023
Name:PEBBLES, GIULIANA E
Entity Type:Individual
Prefix:
First Name:GIULIANA
Middle Name:E
Last Name:PEBBLES
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 1:2009 N PENIEL AVE
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:OK
Mailing Address - Zip Code:73008-5966
Mailing Address - Country:US
Mailing Address - Phone:405-440-0570
Mailing Address - Fax:
Practice Address - Street 1:2009 N PENIEL AVE
Practice Address - Street 2:
Practice Address - City:BETHANY
Practice Address - State:OK
Practice Address - Zip Code:73008-5966
Practice Address - Country:US
Practice Address - Phone:405-440-0570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health