Doctor Name: | MRS. BETH A MASSEY |
NPI Number: | 1063723203 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.ED, LPC |
License Number: | 4340 |
Business Practice Address: | 115 E 1st St Watonga, OK - 737723817 |
Business Phone Number: | 5806239191 |
Business Fax Number: | |
Mailing Address: | 300 N Sampson Ave, WATONGA |
State: | OK |
Postal Code: | 737722628 |
Phone Number: | 5806239191 |
Fax Number: | |
NPI Enumeration Date: | 06/22/2010 |
NPI Last Update Date: | 06/22/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 4340 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |