Provider Demographics
NPI:1720229115
Name:WILLIAMS, MYRNA JEAN (LPC)
Entity Type:Individual
Prefix:MS
First Name:MYRNA
Middle Name:JEAN
Last Name:WILLIAMS
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 1:824 ANNIE CT
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-4236
Mailing Address - Country:US
Mailing Address - Phone:405-812-5934
Mailing Address - Fax:405-364-2697
Practice Address - Street 1:824 ANNIE CT
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-4236
Practice Address - Country:US
Practice Address - Phone:405-812-5934
Practice Address - Fax:405-364-2697
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-13
Last Update Date:2009-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2681101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor