Provider Demographics
NPI:1922146315
Name:GAXIOLA-OAKLEY, BLANCA NORA (MS, LPC)
Entity Type:Individual
Prefix:MS
First Name:BLANCA
Middle Name:NORA
Last Name:GAXIOLA-OAKLEY
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6505 W 42ND ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74107-6008
Mailing Address - Country:US
Mailing Address - Phone:918-446-9587
Mailing Address - Fax:
Practice Address - Street 1:3604 N CINCINNATI AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74106-1536
Practice Address - Country:US
Practice Address - Phone:918-425-4200
Practice Address - Fax:918-425-4202
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3731101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)