Provider Demographics
NPI:1346534575
Name:STOVER, DEBORA L (LPC)
Entity Type:Individual
Prefix:MS
First Name:DEBORA
Middle Name:L
Last Name:STOVER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:DEBBIE
Other - Middle Name:
Other - Last Name:STOVER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:4717 FAWN RUN DR
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-2341
Mailing Address - Country:US
Mailing Address - Phone:405-265-0280
Mailing Address - Fax:
Practice Address - Street 1:6701 BROADWAY EXT
Practice Address - Street 2:SUITE 210
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-8237
Practice Address - Country:US
Practice Address - Phone:405-242-2242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-06
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3063101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor