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General NPI Number Information
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NPI Number | 1730666124
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Entity Type | Organization
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Legal Business Name | PATTI MASON, PLLC.
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Dates
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Enumeration Date | 07/27/2018
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Last Update Date | 07/27/2018
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Provider Practice Location Address
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Address Line | 6023 NW 120TH CT
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City | OKLAHOMA CITY
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State | OK
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Zip | 73162-1790
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Country | US
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Telephone | 405-509-1050
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Fax |
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Provider Business Mailing Address
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Address Line | 6023 NW 120TH CT
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City | OKLAHOMA CITY
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State | OK
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Zip | 73162-1790
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Country | US
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Telephone | 405-509-1050
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | PATRICIA MASON
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Credential | LADC
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Telephone | 405-509-1050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1051
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License Number State | OK
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