Healthcare Provider Details

I. General information

NPI: 1811406523
Provider Name (Legal Business Name): VICTORIA ALLISON FRIESEN MRC, LPC, NCC, CRC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VICTORIA ALLISON WEAVER SAME

II. Dates (important events)

Enumeration Date: 09/26/2017
Last Update Date: 01/13/2020
Certification Date: 01/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4219 S WESTERN AVE
OKLAHOMA CITY OK
73109-3410
US

IV. Provider business mailing address

5300 N INDEPENDENCE AVE STE 280
OKLAHOMA CITY OK
73112-5555
US

V. Phone/Fax

Practice location:
  • Phone: 405-644-5356
  • Fax: 405-636-7946
Mailing address:
  • Phone: 405-644-5356
  • Fax: 405-636-7946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number7130
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: