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General NPI Number Information
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NPI Number | 1245794411
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Entity Type | Organization
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Legal Business Name | OKLAHOMA PSYCHIATRIC FAMILY CLINIC, INC
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Dates
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Enumeration Date | 01/22/2019
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 304 S PARK LANE UNIT B
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City | ALTUS
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State | OK
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Zip | 73521-5754
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Country | US
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Telephone | 580-248-3900
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Fax | 580-248-1987
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Provider Business Mailing Address
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Address Line | PO BOX 328
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City | OLUSTEE
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State | OK
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Zip | 73560-0328
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Country | US
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Telephone | 580-248-3900
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Fax | 580-248-1987
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Authorized Official
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Title or Position | DIRECTOR
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Name | VERNA FAY HENNING
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Credential | LPC
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Telephone | 580-248-3900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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