Provider Demographics
NPI:1922751999
Name:LAVICTOIRE, LENORA ELAINE
Entity Type:Individual
Prefix:
First Name:LENORA
Middle Name:ELAINE
Last Name:LAVICTOIRE
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 1:3221 NW 27TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73107-1921
Mailing Address - Country:US
Mailing Address - Phone:405-659-2926
Mailing Address - Fax:
Practice Address - Street 1:3131 N. PENNSLYVANIA
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-7311
Practice Address - Country:US
Practice Address - Phone:405-459-7478
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-31
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator