Provider Demographics
NPI:1457604720
Name:CREGGETT, EVELYN (BHRS)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:
Last Name:CREGGETT
Suffix:
Gender:F
Credentials:BHRS
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 462
Mailing Address - Street 2:
Mailing Address - City:LANGSTON
Mailing Address - State:OK
Mailing Address - Zip Code:73050-0462
Mailing Address - Country:US
Mailing Address - Phone:918-933-8935
Mailing Address - Fax:
Practice Address - Street 1:1200 N PERKINS RD
Practice Address - Street 2:APT M1
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74075-7104
Practice Address - Country:US
Practice Address - Phone:918-933-8935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-23
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor