Provider Demographics
NPI:1659660827
Name:BLACK-HOOKS, ERICA DENISE (BS,LBRS,INTERN)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:DENISE
Last Name:BLACK-HOOKS
Suffix:
Gender:F
Credentials:BS,LBRS,INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11804 VAIL DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-1646
Mailing Address - Country:US
Mailing Address - Phone:405-205-3236
Mailing Address - Fax:
Practice Address - Street 1:2242 NW 39TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-8884
Practice Address - Country:US
Practice Address - Phone:405-602-3171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-28
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional