Healthcare Provider Details

I. General information

NPI: 1528705100
Provider Name (Legal Business Name): MACY JO CHO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2022
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2617 GENERAL PERSHING BLVD
OKLAHOMA CITY OK
73107-6437
US

IV. Provider business mailing address

2617 GENERAL PERSHING BLVD
OKLAHOMA CITY OK
73107-6437
US

V. Phone/Fax

Practice location:
  • Phone: 580-530-1646
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number13489
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: