Healthcare Provider Details

I. General information

NPI: 1982471561
Provider Name (Legal Business Name): DIXIE LEE (HOWELL) HURD LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/05/2023
Last Update Date: 12/05/2023
Certification Date: 12/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4045 NW 64TH ST STE 520
OKLAHOMA CITY OK
73116-8608
US

IV. Provider business mailing address

4045 NW 64TH ST STE 520
OKLAHOMA CITY OK
73116-8608
US

V. Phone/Fax

Practice location:
  • Phone: 405-842-4911
  • Fax: 405-842-5807
Mailing address:
  • Phone: 405-842-4911
  • Fax: 405-842-5807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number1299
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: