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General NPI Number Information
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NPI Number | 1972895357
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Entity Type | Organization
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Legal Business Name | MICHELLE VERNON, PLLC
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Dates
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Enumeration Date | 05/04/2011
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Last Update Date | 05/04/2011
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Provider Practice Location Address
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Address Line | 6922 S WESTERN AVE SUITE 101
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City | OKLAHOMA CITY
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State | OK
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Zip | 73139-1803
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Country | US
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Telephone | 405-245-9233
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Fax | 405-632-2803
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Provider Business Mailing Address
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Address Line | 13071 FAIRWAY DR
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City | CHOCTAW
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State | OK
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Zip | 73020-8147
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Country | US
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Telephone | 405-245-9233
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Fax | 405-632-2803
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MICHELLE LEE VERNON
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Credential | M.A., LBP
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Telephone | 405-245-9233
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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 | 89
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License Number State | OK
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