Provider Demographics
NPI:1457014243
Name:WELLMAN, SANDRA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:
Last Name:WELLMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1904
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74802-1904
Mailing Address - Country:US
Mailing Address - Phone:405-255-4414
Mailing Address - Fax:
Practice Address - Street 1:1181 E MAIN ST
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-5331
Practice Address - Country:US
Practice Address - Phone:405-364-0333
Practice Address - Fax:405-364-0342
Is Sole Proprietor?:No
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional