Provider Demographics
NPI:1811406523
Name:FRIESEN, VICTORIA ALLISON (MRC, LPC, NCC, CRC)
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:ALLISON
Last Name:FRIESEN
Suffix:
Gender:F
Credentials:MRC, LPC, NCC, CRC
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:ALLISON
Other - Last Name:WEAVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SAME
Mailing Address - Street 1:5300 N INDEPENDENCE AVE STE 280
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-5555
Mailing Address - Country:US
Mailing Address - Phone:405-644-5356
Mailing Address - Fax:405-636-7946
Practice Address - Street 1:4219 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73109-3410
Practice Address - Country:US
Practice Address - Phone:405-644-5356
Practice Address - Fax:405-636-7946
Is Sole Proprietor?:No
Enumeration Date:2017-09-26
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7130101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional