Healthcare Provider Details

I. General information

NPI: 1033028782
Provider Name (Legal Business Name): AGORA TREE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33599 E PVT 1625 RD
PAULS VALLEY OK
73075-0020
US

IV. Provider business mailing address

PO BOX 51
PAULS VALLEY OK
73075-0051
US

V. Phone/Fax

Practice location:
  • Phone: 406-208-6506
  • Fax:
Mailing address:
  • Phone: 406-208-6506
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: AUTUMN LEIGH DOBBS
Title or Position: OWNER, PSYCHOTHERAPIST
Credential: LCPC, LAC
Phone: 406-208-6506