Healthcare Provider Details
I. General information
NPI: 1124400635
Provider Name (Legal Business Name): KEYS FOR HOPE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/20/2015
Last Update Date: 01/11/2023
Certification Date: 01/11/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14020 N WESTERN AVE
EDMOND OK
73013-1977
US
IV. Provider business mailing address
14020 N WESTERN AVE
EDMOND OK
73013-1977
US
V. Phone/Fax
- Phone: 405-822-7844
- Fax: 405-493-6760
- Phone: 405-822-7844
- Fax: 405-493-6760
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | 1206 |
| License Number State | OK |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | 1206 |
| License Number State | OK |
VIII. Authorized Official
Name: DR.
TAMARA
TROWER
Title or Position: OWNER/PSYCHOLOGIST
Credential: PHD
Phone: 405-822-7844