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General NPI Number Information
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NPI Number | 1235433475
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Entity Type | Organization
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Legal Business Name | CONQUERING TRANSITIONS
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Dates
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Enumeration Date | 01/03/2011
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Last Update Date | 01/03/2011
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Provider Practice Location Address
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Address Line | 1002 E VIRGINIA AVE SUITE B
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City | STILLWATER
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State | OK
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Zip | 74075-7942
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Country | US
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Telephone | 405-372-2913
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Fax |
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Provider Business Mailing Address
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Address Line | 1002 E VIRGINIA AVE SUITE B
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City | STILLWATER
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State | OK
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Zip | 74075-7942
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Country | US
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Telephone | 405-372-2913
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Fax |
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Authorized Official
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Title or Position | OWNER/LICENSED PROFESSIONAL COUNSEL
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Name | JENNIFER SMITH
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Credential | MCP, LPC
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Telephone | 918-978-1109
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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 | 4302
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License Number State | OK
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