Healthcare Provider Details

I. General information

NPI: 1932439643
Provider Name (Legal Business Name): BRIGGS FAMILY YOUTH ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/30/2009
Last Update Date: 12/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 N SHARTEL AVE
OKLAHOMA CITY OK
73103-2400
US

IV. Provider business mailing address

623 NW 109TH ST
OKLAHOMA CITY OK
73114-6828
US

V. Phone/Fax

Practice location:
  • Phone: 405-521-8635
  • Fax:
Mailing address:
  • Phone: 405-863-5724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LARRENDA D PATTERSON
Title or Position: THERAPIST
Credential: MS, LPC(CANADIATE),
Phone: 405-863-5724