Provider Demographics
NPI:1932525573
Name:COCHRANE, ELLOUISE
Entity Type:Individual
Prefix:
First Name:ELLOUISE
Middle Name:
Last Name:COCHRANE
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 1:6237 S 86TH EAST AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-1322
Mailing Address - Country:US
Mailing Address - Phone:918-852-3170
Mailing Address - Fax:
Practice Address - Street 1:6237 S 86TH EAST AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-1322
Practice Address - Country:US
Practice Address - Phone:918-852-3170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-06
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst