=====================================================
General NPI Number Information
=====================================================
NPI Number | 1710168463
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | WENDY SUE ALLARD LPC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/23/2007
-----------------------------------------------------
Last Update Date | 07/13/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2525 NW EXPRESSWAY SUITE 608-B
-----------------------------------------------------
City | OKLAHOMA CITY
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73112-7227
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-388-8458
-----------------------------------------------------
Fax | 405-848-2214
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2525 NW EXPRESSWAY SUITE 608-B
-----------------------------------------------------
City | OKLAHOMA CITY
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73112-7227
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-388-8458
-----------------------------------------------------
Fax | 405-848-2214
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 3844
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------