Healthcare Provider Details

I. General information

NPI: 1053916346
Provider Name (Legal Business Name): MORGAN ELISE MEFFORD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2020
Last Update Date: 04/13/2023
Certification Date: 04/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7806 E 108TH ST
TULSA OK
74133-7412
US

IV. Provider business mailing address

3513 S CHRISTINE LN
SAND SPRINGS OK
74063-5033
US

V. Phone/Fax

Practice location:
  • Phone: 918-296-7746
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number11397
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: