Provider Demographics
NPI:1891562153
Name:AMARILLAS, STEPHANIE MICHELE (MSBA)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:MICHELE
Last Name:AMARILLAS
Suffix:
Gender:F
Credentials:MSBA
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:MICHELE
Other - Last Name:WELCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3700 12TH AVE SE APT 714
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-8324
Mailing Address - Country:US
Mailing Address - Phone:720-850-3261
Mailing Address - Fax:
Practice Address - Street 1:400 N WALKER AVE STE 190
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73102-1896
Practice Address - Country:US
Practice Address - Phone:405-943-3700
Practice Address - Fax:405-943-3701
Is Sole Proprietor?:No
Enumeration Date:2023-12-07
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator