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General NPI Number Information
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NPI Number | 1669751426
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Entity Type | Organization
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Legal Business Name | THE COUNSELING OFFICES OF RANDY L CROWNOVER, LMFT, LLC
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Dates
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Enumeration Date | 08/11/2011
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Last Update Date | 08/11/2011
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Provider Practice Location Address
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Address Line | 3233 E MEMORIAL RD SUITE 110
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City | EDMOND
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State | OK
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Zip | 73013-7082
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Country | US
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Telephone | 405-819-1349
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Fax |
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Provider Business Mailing Address
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Address Line | 1700 CAMDEN WAY
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City | EDMOND
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State | OK
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Zip | 73013-2975
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Country | US
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Telephone | 405-819-1349
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RANDY L CROWNOVER
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Credential | LMFT
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Telephone | 405-819-1349
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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 | 911
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License Number State | OK
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