Provider Demographics
NPI:1295304095
Name:MAKES CRY, HEATHER ANN
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:ANN
Last Name:MAKES CRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1652
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:OK
Mailing Address - Zip Code:73008-1652
Mailing Address - Country:US
Mailing Address - Phone:405-981-8246
Mailing Address - Fax:
Practice Address - Street 1:525 LIBERTY LN
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-9046
Practice Address - Country:US
Practice Address - Phone:405-726-8966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-24
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health