Provider Demographics
NPI:1487953881
Name:IBRAHIM, DOROTHY S (BHRS)
Entity type:Individual
Prefix:MRS
First Name:DOROTHY
Middle Name:S
Last Name:IBRAHIM
Suffix:
Gender:F
Credentials:BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 NAPOLI CT
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-8660
Mailing Address - Country:US
Mailing Address - Phone:405-413-4554
Mailing Address - Fax:
Practice Address - Street 1:109 NAPOLI CT
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-8660
Practice Address - Country:US
Practice Address - Phone:405-413-4554
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-24
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health