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NPI Code Detail

MEDICARE: LORIEN O HOLMAN LPC

MEDICARE:   LORIEN O HOLMAN  LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor5267OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15267OTHEROKOKLAHOMA STATE BOARD OF BEHAVIORAL HEALTH LICENSURE

General Provider Information

NPI Number : 1023311495
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORIEN O HOLMAN LPC
Provider Business Mailing Address
First Line : 409 S FRETZ AVE STE C
Second Line :
City : EDMOND
State : OK
Zip : 73003-5570
Country : US
Telephone Number : 405-519-1096
Fax Number :
Provider Business Practice Location Address
First Line : 409 S FRETZ AVE STE C
Second Line :
City : EDMOND
State : OK
Zip : 73003-5570
Country : US
Telephone Number : 405-519-1096
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2010
Last Update Date : 09/01/2016

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Directions to “ LORIEN O HOLMAN LPC” Practice Location

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