Provider Demographics
NPI:1295803815
Name:FEDDER, DEBORAH C (LPC LMFT)
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:C
Last Name:FEDDER
Suffix:
Gender:F
Credentials:LPC LMFT
Other - Prefix:
Other - First Name:DEBBIE
Other - Middle Name:
Other - Last Name:FEDDER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC LMFT
Mailing Address - Street 1:11212 N MAY AVE
Mailing Address - Street 2:STE 203
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-6335
Mailing Address - Country:US
Mailing Address - Phone:405-641-2373
Mailing Address - Fax:405-751-6525
Practice Address - Street 1:11212 N MAY AVE
Practice Address - Street 2:STE 203
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-6335
Practice Address - Country:US
Practice Address - Phone:405-641-2373
Practice Address - Fax:405-751-6525
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2802101YP2500X
OK777106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist