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General NPI Number Information
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NPI Number | 1235469800
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Entity Type | Individual
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Provider Name | WILLIAM HENRY MUKES JR. LMFT
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Gender | Male
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Dates
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Enumeration Date | 01/05/2010
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Last Update Date | 10/18/2012
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Provider Practice Location Address
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Address Line | 2500 S BROADWAY STE 100 SUITE 100
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City | EDMOND
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State | OK
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Zip | 73013-4039
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Country | US
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Telephone | 316-990-1907
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Fax | 405-241-5221
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Provider Business Mailing Address
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Address Line | 2500 S. BROADWAY ST BLDG 100 SUITE 100
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City | EDMOND
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State | OK
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Zip | 73013-4038
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Country | US
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Telephone | 316-990-1907
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Fax | 405-241-5221
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 1041
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 1158
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License Number State | KS
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