Healthcare Provider Details

I. General information

NPI: 1982936548
Provider Name (Legal Business Name): RACHELLE D'FAWN DOWNS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2010
Last Update Date: 08/22/2022
Certification Date: 08/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 LERA STE 5
WEATHERFORD OK
73096-2663
US

IV. Provider business mailing address

2220 PINNACLE DR
WEATHERFORD OK
73096-1050
US

V. Phone/Fax

Practice location:
  • Phone: 580-309-7961
  • Fax:
Mailing address:
  • Phone: 580-309-7961
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2827
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: