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General NPI Number Information
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NPI Number | 1194201723
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Entity Type | Organization
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Legal Business Name | HEART YOUTH & FAMILY THERAPY, INC.
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Dates
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Enumeration Date | 07/17/2018
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Last Update Date | 07/17/2018
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Provider Practice Location Address
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Address Line | 3171 S 129TH EAST AVE # A1161
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City | TULSA
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State | OK
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Zip | 74134-3205
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Country | US
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Telephone | 918-502-5240
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Fax |
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Provider Business Mailing Address
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Address Line | 3171 S 129TH EAST AVE # A1161
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City | TULSA
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State | OK
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Zip | 74134-3205
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Country | US
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Telephone | 918-502-5240
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALEXANDRA MEYERS
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Credential | LPC
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Telephone | 918-982-3700
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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 | 6708
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License Number State | OK
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