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General NPI Number Information
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NPI Number | 1710347828
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Entity Type | Individual
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Provider Name | SARAH WOLF TEDDER
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Gender | Female
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Dates
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Enumeration Date | 03/02/2016
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 624 W INDEPENDENCE ST STE 105
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City | SHAWNEE
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State | OK
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Zip | 74804-4329
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Country | US
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Telephone | 405-279-9416
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Fax |
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Provider Business Mailing Address
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Address Line | 15500 JEFFERSONS GARDEN CT
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City | EDMOND
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State | OK
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Zip | 73013-1410
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Country | US
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Telephone | 405-330-8200
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6546
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License Number State | OK
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