Provider Demographics
NPI:1386963650
Name:LOFTIES, ALLISON MARIE (BA)
Entity type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:MARIE
Last Name:LOFTIES
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7565 E US HIGHWAY 66
Mailing Address - Street 2:
Mailing Address - City:EL RENO
Mailing Address - State:OK
Mailing Address - Zip Code:73036-9120
Mailing Address - Country:US
Mailing Address - Phone:405-262-6555
Mailing Address - Fax:405-262-6557
Practice Address - Street 1:7565 E US HIGHWAY 66
Practice Address - Street 2:
Practice Address - City:EL RENO
Practice Address - State:OK
Practice Address - Zip Code:73036-9120
Practice Address - Country:US
Practice Address - Phone:405-262-6555
Practice Address - Fax:405-262-6557
Is Sole Proprietor?:No
Enumeration Date:2010-05-25
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100731420AMedicaid