Provider Demographics
NPI:1760665657
Name:NABORS, STEPHANIE MARIA
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:MARIA
Last Name:NABORS
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 1:4911 N PORTLAND AVE
Mailing Address - Street 2:SUITE 111
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-6171
Mailing Address - Country:US
Mailing Address - Phone:405-605-3093
Mailing Address - Fax:405-604-5682
Practice Address - Street 1:4911 N PORTLAND AVE
Practice Address - Street 2:SUITE 111
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-6171
Practice Address - Country:US
Practice Address - Phone:405-605-3093
Practice Address - Fax:405-604-5682
Is Sole Proprietor?:No
Enumeration Date:2007-12-13
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker