Provider Demographics
NPI:1396031290
Name:STREICH, HEATHER EILEEN (MS, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:EILEEN
Last Name:STREICH
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 S CINCINNATI AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74103-5048
Mailing Address - Country:US
Mailing Address - Phone:918-381-4313
Mailing Address - Fax:
Practice Address - Street 1:403 S CINCINNATI AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74103-5048
Practice Address - Country:US
Practice Address - Phone:918-381-4313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-20
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK736106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist