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General NPI Number Information
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NPI Number | 1891933438
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Entity Type | Organization
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Legal Business Name | HEART & SOUL PROFESSIONAL COUNSELING SERVICES, INC.
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Dates
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Enumeration Date | 02/03/2009
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Last Update Date | 02/03/2009
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Provider Practice Location Address
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Address Line | 2701 1/2 E MAIN ST
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City | WEATHERFORD
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State | OK
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Zip | 73096-2641
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Country | US
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Telephone | 580-774-2833
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Fax | 580-774-2803
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Provider Business Mailing Address
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Address Line | PO BOX 643
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City | WEATHERFORD
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State | OK
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Zip | 73096-0643
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Country | US
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Telephone | 580-774-2833
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Fax | 580-774-2803
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Authorized Official
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Title or Position | THERAPIST
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Name | MRS. ANDRA RENAEL EPPERLY
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Credential | LPC
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Telephone | 580-774-2833
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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 | 1545
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License Number State | OK
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