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General NPI Number Information
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NPI Number | 1538119417
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Entity Type | Individual
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Provider Name | SALLIE L TRECEK LPC
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Gender | Female
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5525 E 51ST ST SUITE #400
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City | TULSA
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State | OK
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Zip | 74135-7461
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Country | US
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Telephone | 918-388-6251
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Fax | 918-388-6456
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Provider Business Mailing Address
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Address Line | 1627 S QUINCY AVE
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City | TULSA
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State | OK
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Zip | 74120-6408
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Country | US
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Telephone | 918-599-0961
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 1677
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License Number State | OK
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