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General NPI Number Information
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NPI Number | 1871196980
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Entity Type | Individual
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Provider Name | AUDREY ROSE GALVIN MHR, LPC
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Gender | Female
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Dates
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Enumeration Date | 11/19/2020
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Last Update Date | 12/13/2022
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Provider Practice Location Address
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Address Line | 909 ALAMEDA ST
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City | NORMAN
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State | OK
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Zip | 73071-5229
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Country | US
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Telephone | 405-360-5100
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Fax |
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Provider Business Mailing Address
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Address Line | 808 SW 19TH ST APT 206
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City | MOORE
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State | OK
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Zip | 73160-2007
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Country | US
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Telephone | 405-812-5438
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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