Provider Demographics
NPI:1255345583
Name:GILES, CHRISTOPHER R (LMFT)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:R
Last Name:GILES
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6804 S CANTON AVE
Mailing Address - Street 2:SUITE 120
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3423
Mailing Address - Country:US
Mailing Address - Phone:539-664-4235
Mailing Address - Fax:
Practice Address - Street 1:6804 S CANTON AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-3423
Practice Address - Country:US
Practice Address - Phone:539-664-4235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-29
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK817106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist