Provider Demographics
NPI:1962523399
Name:ASTLE, BECKY LYNN (BA)
Entity type:Individual
Prefix:
First Name:BECKY
Middle Name:LYNN
Last Name:ASTLE
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:BECKY
Other - Middle Name:LYNN
Other - Last Name:FITZGERALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:5116 E 84TH PL
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-2017
Mailing Address - Country:US
Mailing Address - Phone:580-716-3591
Mailing Address - Fax:
Practice Address - Street 1:2325 S HARVARD AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74114-3300
Practice Address - Country:US
Practice Address - Phone:918-712-4301
Practice Address - Fax:918-560-1399
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator