Provider Demographics
NPI:1750677746
Name:DELIA THERAPY AND COUNSELING
Entity Type:Organization
Organization Name:DELIA THERAPY AND COUNSELING
Other - Org Name:DTC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWER/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:W
Authorized Official - Last Name:DELIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:918-790-2890
Mailing Address - Street 1:202 EAST CHEROKEE ST
Mailing Address - Street 2:
Mailing Address - City:SALLISAW
Mailing Address - State:OK
Mailing Address - Zip Code:74955
Mailing Address - Country:US
Mailing Address - Phone:918-790-2890
Mailing Address - Fax:918-790-2906
Practice Address - Street 1:202 E CHEROKEE AVE
Practice Address - Street 2:
Practice Address - City:SALLISAW
Practice Address - State:OK
Practice Address - Zip Code:74955-4600
Practice Address - Country:US
Practice Address - Phone:918-790-2890
Practice Address - Fax:918-790-2906
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DELIA MEDICAL CLINIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health