Provider Demographics
NPI:1942521919
Name:COX, AMY E (MS)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:E
Last Name:COX
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 580700
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74158
Mailing Address - Country:US
Mailing Address - Phone:918-430-0975
Mailing Address - Fax:918-430-0995
Practice Address - Street 1:2442 MOHAWK BLVD
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74110
Practice Address - Country:US
Practice Address - Phone:918-430-0975
Practice Address - Fax:918-430-0995
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-14
Last Update Date:2020-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1172101YA0400X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200375610AMedicaid