Provider Demographics
NPI:1659546539
Name:CHENOWETH, ELIZABETH RENEE-TOTH
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:RENEE-TOTH
Last Name:CHENOWETH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:RENEE
Other - Last Name:TOTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4221 W MEMPHIS ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-4634
Mailing Address - Country:US
Mailing Address - Phone:419-618-5999
Mailing Address - Fax:
Practice Address - Street 1:1501 W. COMMERCE
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099
Practice Address - Country:US
Practice Address - Phone:405-354-1927
Practice Address - Fax:405-354-3927
Is Sole Proprietor?:No
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