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General NPI Number Information
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NPI Number | 1932309036
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Entity Type | Individual
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Provider Name | STEPHEN DWIGHT RICHEY L.P.C.
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Gender | Male
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Dates
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Enumeration Date | 07/18/2007
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Last Update Date | 07/18/2007
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Provider Practice Location Address
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Address Line | 109 W PAUL AVE
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City | PAULS VALLEY
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State | OK
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Zip | 73075-3218
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Country | US
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Telephone | 405-329-3349
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Fax | 405-364-3519
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Provider Business Mailing Address
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Address Line | 4436 NW 50TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73112-2212
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Country | US
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Telephone | 405-329-3249
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Fax | 405-364-3519
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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 | 3700
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License Number State | OK
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