Provider Demographics
NPI:1679663728
Name:PEDERSON-RAMBO, MORNA RUTH (MA, LPC, LMFT)
Entity Type:Individual
Prefix:MS
First Name:MORNA
Middle Name:RUTH
Last Name:PEDERSON-RAMBO
Suffix:
Gender:F
Credentials:MA, LPC, LMFT
Other - Prefix:MS
Other - First Name:MORNA
Other - Middle Name:RUTH
Other - Last Name:PEDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:400 NW 34TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118-8647
Mailing Address - Country:US
Mailing Address - Phone:405-525-6139
Mailing Address - Fax:
Practice Address - Street 1:5525 E 51ST ST
Practice Address - Street 2:SUITE #400
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-7461
Practice Address - Country:US
Practice Address - Phone:918-388-6438
Practice Address - Fax:918-388-6456
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK661101YP2500X
OK518106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist