Provider Demographics
NPI:1144821828
Name:NATION, MARIAN PAIGE
Entity type:Individual
Prefix:
First Name:MARIAN
Middle Name:PAIGE
Last Name:NATION
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 1:2405 WAYNE CUTT AVE
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-9676
Mailing Address - Country:US
Mailing Address - Phone:405-698-9464
Mailing Address - Fax:
Practice Address - Street 1:3700 N CLASSEN BLVD STE 185
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-2881
Practice Address - Country:US
Practice Address - Phone:405-225-1891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-08
Last Update Date:2020-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty