Healthcare Provider Details

I. General information

NPI: 1699901330
Provider Name (Legal Business Name): MEGAN N KOGER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MEGAN PARRISH

II. Dates (important events)

Enumeration Date: 06/09/2009
Last Update Date: 02/07/2020
Certification Date: 02/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

849 E 33RD ST
EDMOND OK
73013-5407
US

IV. Provider business mailing address

6712 NE 101ST ST
OKLAHOMA CITY OK
73151-9154
US

V. Phone/Fax

Practice location:
  • Phone: 405-888-5299
  • Fax: 405-888-5322
Mailing address:
  • Phone: 405-590-1340
  • Fax: 405-463-6635

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5338
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: