Provider Demographics
NPI:1669791992
Name:POSLICK, TINA MARIE
Entity type:Individual
Prefix:MRS
First Name:TINA
Middle Name:MARIE
Last Name:POSLICK
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 1:526 E BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73701-4209
Mailing Address - Country:US
Mailing Address - Phone:580-402-3356
Mailing Address - Fax:
Practice Address - Street 1:526 E BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-4209
Practice Address - Country:US
Practice Address - Phone:580-402-3356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-26
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor