Provider Demographics
NPI:1275196461
Name:REMBERT-ANDERSON, PATRICIA LYNN (MHR, LPC, NCC)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:LYNN
Last Name:REMBERT-ANDERSON
Suffix:
Gender:F
Credentials:MHR, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1704 NW 45TH ST
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-3625
Mailing Address - Country:US
Mailing Address - Phone:580-341-7177
Mailing Address - Fax:800-886-3338
Practice Address - Street 1:1704 NW 45TH ST
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-3625
Practice Address - Country:US
Practice Address - Phone:580-341-7177
Practice Address - Fax:800-886-3338
Is Sole Proprietor?:No
Enumeration Date:2019-04-15
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX93160101YP2500X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional