Provider Demographics
NPI:1255469953
Name:WIMMER-STEVES, DONNA SUE (MS, LPC, LBP)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:SUE
Last Name:WIMMER-STEVES
Suffix:
Gender:F
Credentials:MS, LPC, LBP
Other - Prefix:MS
Other - First Name:DONNA
Other - Middle Name:SUE
Other - Last Name:WIMMER-STEVES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, LPC, LBP
Mailing Address - Street 1:1102 W CUMMINGS ST
Mailing Address - Street 2:
Mailing Address - City:HENRYETTA
Mailing Address - State:OK
Mailing Address - Zip Code:74437-2422
Mailing Address - Country:US
Mailing Address - Phone:918-650-0161
Mailing Address - Fax:
Practice Address - Street 1:711 N BULLITT ST
Practice Address - Street 2:
Practice Address - City:HOLDENVILLE
Practice Address - State:OK
Practice Address - Zip Code:74848-3804
Practice Address - Country:US
Practice Address - Phone:405-379-6668
Practice Address - Fax:405-379-5372
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK0016101YM0800X
OK9874101YM0800X
OK2146101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional