Provider Demographics
NPI:1891046686
Name:COLBERT, UTE ELIZABETH
Entity Type:Individual
Prefix:MRS
First Name:UTE
Middle Name:ELIZABETH
Last Name:COLBERT
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:UTE
Other - Middle Name:E
Other - Last Name:HOLLINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:RR 1 BOX 91
Mailing Address - Street 2:
Mailing Address - City:CASHION
Mailing Address - State:OK
Mailing Address - Zip Code:73016-9503
Mailing Address - Country:US
Mailing Address - Phone:405-210-6966
Mailing Address - Fax:
Practice Address - Street 1:4209 NW 23RD ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73107-2645
Practice Address - Country:US
Practice Address - Phone:405-917-1709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-20
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst