Basic Information
| Provider Information | |||||||||
| NPI: | 1578929295 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LINDLEY | ||||||||
| FirstName: | CABRINA | ||||||||
| MiddleName: | LASHAWN | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | M.ES | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherMiddleName: | |||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | |||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 580700 | ||||||||
| Address2: | 2442 MOHAWK BLVD, TULSA | ||||||||
| City: | TULSA | ||||||||
| State: | OK | ||||||||
| PostalCode: | 741580700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9184300975 | ||||||||
| FaxNumber: | 9184300995 | ||||||||
| Practice Location | |||||||||
| Address1: | 2442 MOHAWK BLVD | ||||||||
| Address2: | |||||||||
| City: | TULSA | ||||||||
| State: | OK | ||||||||
| PostalCode: | 741101519 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9184300975 | ||||||||
| FaxNumber: | 9184300995 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/11/2016 | ||||||||
| LastUpdateDate: | 01/11/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171M00000X | Y | Other Service Providers | Case Manager/Care Coordinator |
No ID Information.