Provider Demographics
NPI:1881461812
Name:THORNBRUE, PATTSI ANN (BCMMHC)
Entity type:Individual
Prefix:
First Name:PATTSI
Middle Name:ANN
Last Name:THORNBRUE
Suffix:
Gender:F
Credentials:BCMMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9900 S BRYANT RD
Mailing Address - Street 2:
Mailing Address - City:GUTHRIE
Mailing Address - State:OK
Mailing Address - Zip Code:73044-9595
Mailing Address - Country:US
Mailing Address - Phone:405-627-0354
Mailing Address - Fax:
Practice Address - Street 1:6809 N BROADWAY
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-7818
Practice Address - Country:US
Practice Address - Phone:140-562-7035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-11
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health