Provider Demographics
NPI:1932113552
Name:DONALDSON, ELLEN L (LMFT, LADC)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:L
Last Name:DONALDSON
Suffix:
Gender:F
Credentials:LMFT, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 RAVENWOOD LN
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-7426
Mailing Address - Country:US
Mailing Address - Phone:405-360-3191
Mailing Address - Fax:
Practice Address - Street 1:330 W GRAY ST
Practice Address - Street 2:#100-6C
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-7129
Practice Address - Country:US
Practice Address - Phone:405-360-3191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist