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General NPI Number Information
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NPI Number | 1871622217
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Entity Type | Organization
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Legal Business Name | CHRISTIAN COUNSELING, PLLC
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 412 N TELEPHONE RD
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City | MOORE
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State | OK
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Zip | 73160-4920
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Country | US
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Telephone | 405-794-5552
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Fax | 405-759-2402
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Provider Business Mailing Address
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Address Line | 412 N TELEPHONE RD
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City | MOORE
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State | OK
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Zip | 73160-4920
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Country | US
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Telephone | 405-794-5552
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Fax | 405-759-2402
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Authorized Official
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Title or Position | OWNER
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Name | MRS. GLORIA J MCCREARY
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Credential | M ED
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Telephone | 405-794-5552
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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 |
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License Number State |
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