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General NPI Number Information
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NPI Number | 1013227917
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Entity Type | Organization
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Legal Business Name | THE MARRIAGE & FAMILY CLINIC OF TULSA, INC
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Dates
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Enumeration Date | 10/14/2010
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 7633 E. 63RD PLACE SUITE 300
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City | TULSA
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State | OK
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Zip | 74133
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Country | US
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Telephone | 918-695-2495
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 864
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City | OWASSO
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State | OK
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Zip | 74055
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. BRAD ROBINSON
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Credential | LMFT
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Telephone | 918-695-2495
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | OK
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