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General NPI Number Information
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NPI Number | 1639502545
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Entity Type | Organization
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Legal Business Name | BONNY PARKHURST, LPC, PLLC
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Dates
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Enumeration Date | 08/14/2013
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Last Update Date | 08/14/2013
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Provider Practice Location Address
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Address Line | 1201 E 33RD ST
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City | TULSA
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State | OK
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Zip | 74105-2017
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Country | US
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Telephone | 918-292-9432
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Fax |
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Provider Business Mailing Address
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Address Line | 4524 S KINGSTON AVE
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City | TULSA
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State | OK
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Zip | 74135-6536
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Country | US
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Telephone | 918-292-9432
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Fax |
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Authorized Official
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Title or Position | OWNER / LICENSED COUNSELOR
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Name | BONNY PARKHURST
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Credential | MS, LPC
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Telephone | 918-202-9432
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number | 5006
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License Number State | OK
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