MEDICARE: KEIFER COUNSELING, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	941	OK

General Provider Information

NPI Number	:	1659709103
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KEIFER COUNSELING, INC

Provider Business Mailing Address
First Line	:	7502 S TRENTON PL
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74136-7338
Country	:	US
Telephone Number	:	918-407-2136
Fax Number	:

Provider Business Practice Location Address
First Line	:	7502 S TRENTON PL
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74136-7338
Country	:	US
Telephone Number	:	918-407-2136
Fax Number	:

Authorized Official
Title or Position	:	MARRIAGE & FAMILY THERAPIST
Name	:	MRS. BRITTAIN DELYNN KEIFER
Credential	:	MA, LMFT
Telephone Number	:	918-407-2136

Provider Enumeration Date	:	10/20/2013
Last Update Date	:	10/20/2013

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