Provider Demographics
NPI:1124441613
Name:MCALISTER, SAMANTHA RAYE
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:RAYE
Last Name:MCALISTER
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:PO BOX 12978
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73157-2978
Mailing Address - Country:US
Mailing Address - Phone:405-858-2700
Mailing Address - Fax:405-260-3442
Practice Address - Street 1:2403 S DIVISION ST STE C&D
Practice Address - Street 2:
Practice Address - City:GUTHRIE
Practice Address - State:OK
Practice Address - Zip Code:73044-6027
Practice Address - Country:US
Practice Address - Phone:405-260-3441
Practice Address - Fax:405-260-3442
Is Sole Proprietor?:No
Enumeration Date:2014-02-04
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor