Provider Demographics
NPI:1760531677
Name:OMAN, MARIA LYNNE
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:LYNNE
Last Name:OMAN
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 1:329 S 450 W
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84720-3113
Mailing Address - Country:US
Mailing Address - Phone:435-559-4343
Mailing Address - Fax:
Practice Address - Street 1:2202 N MAIN ST
Practice Address - Street 2:SUITE 301
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84720-9765
Practice Address - Country:US
Practice Address - Phone:435-586-4479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT266740-3503101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health