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General NPI Number Information
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NPI Number | 1679451090
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Entity Type | Organization
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Legal Business Name | THIRD SPACE THERAPY NORMAN, LLC
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Dates
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Enumeration Date | 08/25/2025
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Last Update Date | 08/30/2025
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Provider Practice Location Address
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Address Line | 405 E COMANCHE ST
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City | NORMAN
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State | OK
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Zip | 73071-5801
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Country | US
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Telephone | 405-237-9306
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Fax | 844-688-4422
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Provider Business Mailing Address
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Address Line | 2812 DALEWOOD PL
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City | NORMAN
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State | OK
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Zip | 73071-4710
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Country | US
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Telephone | 405-343-0711
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Fax | 844-688-4422
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Authorized Official
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Title or Position | CEO
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Name | HARRIET ANN BOHANAN
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Credential | LPC
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Telephone | 405-343-0711
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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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