Provider Demographics
NPI:1770832412
Name:HOWSE, LAURIECE
Entity Type:Individual
Prefix:MS
First Name:LAURIECE
Middle Name:
Last Name:HOWSE
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:LAURIECE
Other - Middle Name:
Other - Last Name:MILLS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7160 S 92ND EAST AVE
Mailing Address - Street 2:APT. 1303
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-4721
Mailing Address - Country:US
Mailing Address - Phone:918-813-1472
Mailing Address - Fax:
Practice Address - Street 1:11428 E 20TH ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74128-6451
Practice Address - Country:US
Practice Address - Phone:918-878-7877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-07
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200287120AMedicaid