Provider Demographics
NPI:1790732238
Name:HOPE, MARY T (PHD, LPC)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:T
Last Name:HOPE
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37050 HIGHWAY 19
Mailing Address - Street 2:
Mailing Address - City:PAULS VALLEY
Mailing Address - State:OK
Mailing Address - Zip Code:73075-8678
Mailing Address - Country:US
Mailing Address - Phone:405-238-6223
Mailing Address - Fax:405-238-6223
Practice Address - Street 1:37050 HIGHWAY 19
Practice Address - Street 2:
Practice Address - City:PAULS VALLEY
Practice Address - State:OK
Practice Address - Zip Code:73075-8678
Practice Address - Country:US
Practice Address - Phone:405-238-6223
Practice Address - Fax:405-238-6223
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-30
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2666101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional