Provider Demographics
NPI:1114240926
Name:MOREY, GEORGE BRENT (BHRS)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:BRENT
Last Name:MOREY
Suffix:
Gender:M
Credentials:BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 REBECCA RD
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:OK
Mailing Address - Zip Code:73542-2444
Mailing Address - Country:US
Mailing Address - Phone:580-335-3184
Mailing Address - Fax:
Practice Address - Street 1:1500 N MAIN ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:OK
Practice Address - Zip Code:73542-1421
Practice Address - Country:US
Practice Address - Phone:580-335-3320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-08
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK20104101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health