Healthcare Provider Details

I. General information

NPI: 1497181242
Provider Name (Legal Business Name): CHERYL LORRAINE MURDOCK LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2013
Last Update Date: 09/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6801 S DONNA LN
OKLAHOMA CITY OK
73150-6206
US

IV. Provider business mailing address

6801 S DONNA LN
OKLAHOMA CITY OK
73150-6206
US

V. Phone/Fax

Practice location:
  • Phone: 405-637-6210
  • Fax:
Mailing address:
  • Phone: 405-637-6210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2866
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: