Provider Demographics
NPI:1538455373
Name:EFIOM, ALPHONS GREGORY
Entity type:Individual
Prefix:MR
First Name:ALPHONS
Middle Name:GREGORY
Last Name:EFIOM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:656 NW 120TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73114-8309
Mailing Address - Country:US
Mailing Address - Phone:405-889-3640
Mailing Address - Fax:
Practice Address - Street 1:3035 NW 63RD ST STE 201
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-3606
Practice Address - Country:US
Practice Address - Phone:405-842-8801
Practice Address - Fax:405-842-8801
Is Sole Proprietor?:No
Enumeration Date:2011-06-20
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor