Provider Demographics
NPI:1952661779
Name:DELONEY, ANITA JACQUELINE (TEACHER)
Entity Type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:JACQUELINE
Last Name:DELONEY
Suffix:
Gender:F
Credentials:TEACHER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 57365
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73157-7365
Mailing Address - Country:US
Mailing Address - Phone:405-401-9605
Mailing Address - Fax:
Practice Address - Street 1:4040 FONTANA DR
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-1654
Practice Address - Country:US
Practice Address - Phone:405-401-9605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-26
Last Update Date:2012-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health