| Britane Outlaw, Llc | |
|
3280 Marshall Ave Norman OK 73072-8022 | |
| (405) 329-7300 | |
| Not Available |
| Full Name | Britane Outlaw, Llc |
|---|---|
| Speciality | Counselor |
| Location | 3280 Marshall Ave, Norman, Oklahoma |
| Authorized Official Name and Position | Dawn Miller (CREDENTIALING) |
| Authorized Official Contact | 4053297300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Britane Outlaw, Llc 18324 Frontier Trl Norman OK 73072-2031 Ph: (405) 642-8671 | Britane Outlaw, Llc 3280 Marshall Ave Norman OK 73072-8022 Ph: (405) 329-7300 |
| NPI Number | 1972156149 |
|---|---|
| Provider Enumeration Date | 07/17/2019 |
| Last Update Date | 07/17/2019 |
| Medicare PECOS PAC ID | 2567807878 |
|---|---|
| Medicare Enrollment ID | O20240227000527 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972156149 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Britane Outlaw |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366751901 PECOS PAC ID: 4385089697 Enrollment ID: I20240327003584 |
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