Provider Demographics
NPI:1649413725
Name:BATMAN, CELLINI C (BA CADC)
Entity Type:Individual
Prefix:
First Name:CELLINI
Middle Name:C
Last Name:BATMAN
Suffix:
Gender:F
Credentials:BA CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 131
Mailing Address - Street 2:
Mailing Address - City:KENEFIC
Mailing Address - State:OK
Mailing Address - Zip Code:74748-0131
Mailing Address - Country:US
Mailing Address - Phone:580-367-3080
Mailing Address - Fax:
Practice Address - Street 1:5912 US HWY 70
Practice Address - Street 2:
Practice Address - City:MEAD
Practice Address - State:OK
Practice Address - Zip Code:73449
Practice Address - Country:US
Practice Address - Phone:580-745-9083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-20
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)