Healthcare Provider Details

I. General information

NPI: 1497909477
Provider Name (Legal Business Name): SHARON ROSE LEE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2008
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 S WALNUT ST
STILLWATER OK
74074-4222
US

IV. Provider business mailing address

604 S WALNUT ST
STILLWATER OK
74074-4222
US

V. Phone/Fax

Practice location:
  • Phone: 405-372-2202
  • Fax: 405-445-3780
Mailing address:
  • Phone: 405-372-2202
  • Fax: 405-445-3780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: