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General NPI Number Information
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NPI Number | 1518475334
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Entity Type | Organization
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Legal Business Name | THERAPEUTIC CONNECTIONS
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Dates
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Enumeration Date | 01/15/2018
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Last Update Date | 01/15/2018
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Provider Practice Location Address
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Address Line | 2021 S LEWIS AVE STE 325
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City | TULSA
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State | OK
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Zip | 74104-5719
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Country | US
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Telephone | 918-281-5031
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Fax |
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Provider Business Mailing Address
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Address Line | 307 WATERFORD ST
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City | CATOOSA
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State | OK
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Zip | 74015-5990
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Country | US
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Telephone | 918-281-5031
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Fax |
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Authorized Official
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Title or Position | OWNER/PSYCHOTHERAPIST
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Name | MRS. GLENDA GAIL BIEBER
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Credential | LCSW
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Telephone | 918-281-5031
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1194
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License Number State | OK
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