Doctor Name: | TERRI MINOR |
NPI Number: | 1790802312 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LBP |
License Number: | 0003 |
Business Practice Address: | 209 W Broadway St Okemah, OK - 748592618 |
Business Phone Number: | 9186232922 |
Business Fax Number: | 9186239316 |
Mailing Address: | 28705 S 196 Rd, HENRYETTA |
State: | OK |
Postal Code: | 744376830 |
Phone Number: | 9186232922 |
Fax Number: | 9186239316 |
NPI Enumeration Date: | 03/26/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 0003 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |