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NPI Code Detail

MEDICARE: LAURA PROSSER LPC

MEDICARE:   LAURA  PROSSER  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 Counselor6896OK

General Provider Information

NPI Number : 1336528025
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA PROSSER LPC
Provider Business Mailing Address
First Line : 205 W VICTORIA ST
Second Line :
City : TULSA
State : OK
Zip : 74106-3646
Country : US
Telephone Number : 918-229-0817
Fax Number :
Provider Business Practice Location Address
First Line : 2417 E 53RD ST STE 102
Second Line :
City : TULSA
State : OK
Zip : 74105-6600
Country : US
Telephone Number : 405-492-7211
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2015
Last Update Date : 09/26/2024

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Directions to “ LAURA PROSSER LPC” Practice Location

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