Provider Demographics
NPI:1457606329
Name:HERRERA, AZURE LAMONS
Entity Type:Individual
Prefix:MRS
First Name:AZURE
Middle Name:LAMONS
Last Name:HERRERA
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:AZURE
Other - Middle Name:LORRAINE
Other - Last Name:LAMONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2525 NW 33RD ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-7627
Mailing Address - Country:US
Mailing Address - Phone:405-708-9303
Mailing Address - Fax:
Practice Address - Street 1:2525 NW 33RD ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-7627
Practice Address - Country:US
Practice Address - Phone:405-708-9303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-17
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker