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General NPI Number Information
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NPI Number | 1043613672
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Entity Type | Organization
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Legal Business Name | THE THERAPY GROUP
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Dates
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Enumeration Date | 09/26/2014
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Last Update Date | 09/26/2014
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Provider Practice Location Address
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Address Line | 2119 RIVERWALK DR # 173
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City | MOORE
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State | OK
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Zip | 73160-2700
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Country | US
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Telephone | 405-596-0885
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 721673
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City | OKLAHOMA CITY
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State | OK
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Zip | 73172-1673
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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 | COUNSELOR
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Name | CATHERINE MITCHENER
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Credential | MHR, LPC
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Telephone | 405-596-0885
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 5359
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License Number State | OK
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