Provider Demographics
NPI:1487915369
Name:POBEE-MENSAH, VICKIE
Entity type:Individual
Prefix:
First Name:VICKIE
Middle Name:
Last Name:POBEE-MENSAH
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 1:7924 MICHAEL CT
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73132-4330
Mailing Address - Country:US
Mailing Address - Phone:818-472-1766
Mailing Address - Fax:
Practice Address - Street 1:7924 MICHAEL CT
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73132-4330
Practice Address - Country:US
Practice Address - Phone:818-472-1766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK101YM0800XOtherBHRS