Provider Demographics
NPI:1245720184
Name:MARRIS, HELEN LORRAINE
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:LORRAINE
Last Name:MARRIS
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 1:5924 NW 56TH ST
Mailing Address - Street 2:
Mailing Address - City:WARR ACRES
Mailing Address - State:OK
Mailing Address - Zip Code:73122-6107
Mailing Address - Country:US
Mailing Address - Phone:207-200-0140
Mailing Address - Fax:
Practice Address - Street 1:5924 NW 56TH ST
Practice Address - Street 2:
Practice Address - City:WARR ACRES
Practice Address - State:OK
Practice Address - Zip Code:73122-6107
Practice Address - Country:US
Practice Address - Phone:207-200-0140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-16
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional