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General NPI Number Information
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NPI Number | 1982885166
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Entity Type | Individual
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Provider Name | DAVID KEITH PETERS LCSW
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Gender | Male
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Dates
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Enumeration Date | 11/16/2007
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Last Update Date | 03/19/2008
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Provider Practice Location Address
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Address Line | 1535 S LEWIS AVE
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City | TULSA
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State | OK
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Zip | 74104-4919
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Country | US
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Telephone | 918-637-2285
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Fax | 918-561-6001
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Provider Business Mailing Address
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Address Line | 1535 S LEWIS AVE
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City | TULSA
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State | OK
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Zip | 74104-4919
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Country | US
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Telephone | 918-637-2285
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Fax | 918-561-6001
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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 | 1653
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License Number State | OK
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