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General NPI Number Information
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NPI Number | 1629683727
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Entity Type | Organization
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Legal Business Name | MASON COUNSELING SERVICES
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Dates
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Enumeration Date | 09/15/2020
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Last Update Date | 09/15/2020
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Provider Practice Location Address
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Address Line | 12718 E 77TH PL N
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City | OWASSO
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State | OK
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Zip | 74055-7938
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Country | US
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Telephone | 918-740-9447
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Fax |
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Provider Business Mailing Address
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Address Line | 12718 E 77TH PL N
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City | OWASSO
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State | OK
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Zip | 74055-7938
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Country | US
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Telephone | 918-740-9447
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMBER DANIELLE MASON
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Credential | LPC
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Telephone | 918-850-5237
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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