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General NPI Number Information
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NPI Number | 1891272126
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Entity Type | Organization
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Legal Business Name | TERESA REEVES LCSW PLLC
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Dates
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Enumeration Date | 07/19/2018
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Last Update Date | 07/19/2018
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Provider Practice Location Address
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Address Line | 15310 N MAY AVE # 201
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City | EDMOND
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State | OK
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Zip | 73013-8864
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Country | US
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Telephone | 405-938-1444
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Fax | 405-938-1445
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Provider Business Mailing Address
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Address Line | 5085 NW 220TH ST
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City | EDMOND
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State | OK
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Zip | 73025-9167
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Country | US
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Telephone | 405-938-1444
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Fax | 405-938-1445
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Authorized Official
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Title or Position | OWNER
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Name | TERESA REEVES
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Credential | MSW, LCSW
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Telephone | 405-740-0253
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 5029
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License Number State | OK
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