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General NPI Number Information
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NPI Number | 1447580600
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Entity Type | Individual
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Provider Name | TALIESSA JEAN MESCALL LMFT
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Gender | Female
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Dates
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Enumeration Date | 01/10/2010
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Last Update Date | 01/27/2010
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Provider Practice Location Address
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Address Line | 116 W MAIN ST
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City | NORMAN
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State | OK
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Zip | 73069-1307
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Country | US
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Telephone | 405-919-6821
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Fax | 405-701-5843
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Provider Business Mailing Address
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Address Line | 12401 ACADIA CT
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City | OKLAHOMA CITY
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State | OK
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Zip | 73142-4801
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Country | US
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Telephone | 405-720-6761
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Fax | 405-720-6761
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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 | 506
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License Number State | OK
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