Provider Demographics
NPI:1508922642
Name:HURDELBRINK, VERONICA LYNN (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:VERONICA
Middle Name:LYNN
Last Name:HURDELBRINK
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6317 S ASH AVE
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74011-4107
Mailing Address - Country:US
Mailing Address - Phone:918-455-3113
Mailing Address - Fax:
Practice Address - Street 1:9717 E 42ND ST
Practice Address - Street 2:SUITE 208
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74146-3618
Practice Address - Country:US
Practice Address - Phone:918-270-4100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK858106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist