Healthcare Provider Details

I. General information

NPI: 1073966834
Provider Name (Legal Business Name): PEOPLES FAMILY COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2016
Last Update Date: 07/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10306 N 138TH EAST AVE STE 206
OWASSO OK
74055-4665
US

IV. Provider business mailing address

9265 MOCKINGBIRD LN
TALALA OK
74080-9588
US

V. Phone/Fax

Practice location:
  • Phone: 918-695-2059
  • Fax:
Mailing address:
  • Phone: 918-695-2059
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number4906
License Number StateOK

VIII. Authorized Official

Name: BRANDY N PEOPLES
Title or Position: OWNER
Credential: LPC
Phone: 918-695-2059