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General NPI Number Information
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NPI Number | 1033520549
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Entity Type | Individual
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Provider Name | JANIS CULLEY-GARDNER
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Gender | Female
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Dates
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Enumeration Date | 05/19/2014
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Last Update Date | 05/19/2014
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Provider Practice Location Address
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Address Line | 7250 NW EXPRESSWAY 200
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City | OKC
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State | OK
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Zip | 73122-1522
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Country | US
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Telephone | 405-525-0452
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Fax | 405-525-0515
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Provider Business Mailing Address
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Address Line | 445 NW 115TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73114-6732
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Country | US
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Telephone | 405-650-2120
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0117
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License Number State | OK
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