Healthcare Provider Details

I. General information

NPI: 1922962711
Provider Name (Legal Business Name): REBEKAH THOMAS
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 SOVEREIGN ROW STE A
OKLAHOMA CITY OK
73108-1983
US

IV. Provider business mailing address

1508 NW 197TH CIR
EDMOND OK
73012-3472
US

V. Phone/Fax

Practice location:
  • Phone: 405-920-8934
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: