Healthcare Provider Details

I. General information

NPI: 1174779847
Provider Name (Legal Business Name): LINDA HARTZ CHRISTIAN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS LINDA KAY HARTZ

II. Dates (important events)

Enumeration Date: 08/14/2008
Last Update Date: 08/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 N LEE AVE 49 N
OKLAHOMA CITY OK
73102-1036
US

IV. Provider business mailing address

1000 N LEE AVE 49 N
OKLAHOMA CITY OK
73102-1036
US

V. Phone/Fax

Practice location:
  • Phone: 405-272-4934
  • Fax: 405-270-7576
Mailing address:
  • Phone: 405-272-4934
  • Fax: 405-270-7576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2765
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: