Provider Demographics
NPI:1598082349
Name:DOSSER, BREE
Entity Type:Individual
Prefix:
First Name:BREE
Middle Name:
Last Name:DOSSER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3617 NW 58TH ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4487
Mailing Address - Country:US
Mailing Address - Phone:405-420-4553
Mailing Address - Fax:405-943-1795
Practice Address - Street 1:3617 NW 58TH ST
Practice Address - Street 2:SUITE 103
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4487
Practice Address - Country:US
Practice Address - Phone:405-420-4553
Practice Address - Fax:405-943-1795
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-03
Last Update Date:2015-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK101YA0400X
101YM0800X
OK5222101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health