Provider Demographics
NPI:1679938534
Name:MASSEY, CLAUDIA ANTOINETTE
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:ANTOINETTE
Last Name:MASSEY
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 1:1900 HEBRON CT
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-9633
Mailing Address - Country:US
Mailing Address - Phone:405-625-5993
Mailing Address - Fax:
Practice Address - Street 1:301 POINTE PARKWAY BLVD APT 706
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-0641
Practice Address - Country:US
Practice Address - Phone:580-302-2076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-20
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility