Provider Demographics
NPI:1285740688
Name:MOUTON, YVONNE LINDA (CASE MANAGER)
Entity type:Individual
Prefix:MS
First Name:YVONNE
Middle Name:LINDA
Last Name:MOUTON
Suffix:
Gender:F
Credentials:CASE MANAGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 OAKWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:CHOCTAW
Mailing Address - State:OK
Mailing Address - Zip Code:73020
Mailing Address - Country:US
Mailing Address - Phone:405-317-4840
Mailing Address - Fax:405-232-2447
Practice Address - Street 1:600 NW 23RD ST
Practice Address - Street 2:SUITE 101
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73103-1469
Practice Address - Country:US
Practice Address - Phone:405-232-2437
Practice Address - Fax:405-232-2447
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist