Provider Demographics
NPI:1164991022
Name:KEIFER, BRITTAIN D (MA, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:BRITTAIN
Middle Name:D
Last Name:KEIFER
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6762 E 125TH ST S
Mailing Address - Street 2:
Mailing Address - City:BIXBY
Mailing Address - State:OK
Mailing Address - Zip Code:74008-2944
Mailing Address - Country:US
Mailing Address - Phone:918-407-2136
Mailing Address - Fax:
Practice Address - Street 1:6762 E 125TH ST S
Practice Address - Street 2:
Practice Address - City:BIXBY
Practice Address - State:OK
Practice Address - Zip Code:74008-2944
Practice Address - Country:US
Practice Address - Phone:918-407-2136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-20
Last Update Date:2021-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2911235Z00000X
OK941106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist