Provider Demographics
NPI:1396071973
Name:UGARTE, ELIZABETH G
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:G
Last Name:UGARTE
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 1:12208 GREENLEA CHASE E
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73170-6026
Mailing Address - Country:US
Mailing Address - Phone:405-227-3478
Mailing Address - Fax:405-601-6130
Practice Address - Street 1:12208 GREENLEA CHASE E
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73170-6026
Practice Address - Country:US
Practice Address - Phone:405-227-3478
Practice Address - Fax:405-601-6130
Is Sole Proprietor?:No
Enumeration Date:2009-11-02
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health