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NPI 1427656909

NPI 1427656909 : LASHONDA MOBLEY WAITERS, LPC : EDMOND, OK

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General NPI Number Information
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    NPI Number           |    1427656909
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    Entity Type          |    Organization 
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    Legal Business Name  |    LASHONDA MOBLEY WAITERS, LPC 
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Dates
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    Enumeration Date     |    10/15/2020
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    Last Update Date     |    02/23/2022
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Provider Practice Location Address
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    Address Line         |    2701 NW 185TH ST 
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    City                 |    EDMOND
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    State                |    OK
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    Zip                  |    73012-9795
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    Country              |    US
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    Telephone            |    405-625-3168
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2701 NW 185TH ST 
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    City                 |    EDMOND
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    State                |    OK
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    Zip                  |    73012-9795
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    Country              |    US
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    Telephone            |    405-625-3168
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |     LASHONDA  MOBLEY 
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    Credential           |    LPC-S
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    Telephone            |    405-625-3168
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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       |    
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    License Number State |    
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