NPI 1023453602 · live from the CMS NPI Registry
Bison Family Therapy Institute, PLLC
Marriage & Family Therapist in Shawnee, OK. National Provider Identifier 1023453602, active.
NPI record
| NPI | 1023453602 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Marriage & Family Therapist 106H00000X |
| Practice location | 1601 N Kickapoo Ave Ste 900, Shawnee, OK 74804 |
| Practice phone | 405-585-6413 |
| Mailing address | 2007 N Minnesota Ave, Shawnee, OK 74804 |
| Enumerated | May 8, 2013 |
| Last updated | August 29, 2022 |
| Authorized official | Canaan Crane, Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Marriage & Family Therapist primary | 106H00000X | 783 (OK) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.