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General NPI Number Information
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NPI Number | 1730327586
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Entity Type | Individual
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Provider Name | TERRA JO STANSELL L.P.C.
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Gender | Female
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Dates
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Enumeration Date | 02/02/2009
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Last Update Date | 02/02/2009
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Provider Practice Location Address
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Address Line | 2725 E SKELLY DR
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City | TULSA
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State | OK
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Zip | 74105-6241
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Country | US
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Telephone | 918-382-7300
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Fax |
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Provider Business Mailing Address
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Address Line | 3360 W WASHINGTON ST
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City | BROKEN ARROW
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State | OK
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Zip | 74012-9079
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Country | US
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Telephone | 918-706-7173
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 3765
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 3167
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License Number State | OK
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