| The Dysfunctional Couch | |
|
3839 S Boulevard Ste 200 Edmond OK 73013-5495 | |
| (918) 638-4219 | |
| Not Available |
| Full Name | The Dysfunctional Couch |
|---|---|
| Speciality | Counselor - Professional |
| Location | 3839 S Boulevard Ste 200, Edmond, Oklahoma |
| Authorized Official Name and Position | Elizabeth Louise Mitchell (OWNER, THERAPIST) |
| Authorized Official Contact | 9186384219 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Dysfunctional Couch 3839 S Boulevard Ste 200 Edmond OK 73013-5495 Ph: (918) 638-4219 | The Dysfunctional Couch 3839 S Boulevard Ste 200 Edmond OK 73013-5495 Ph: (918) 638-4219 |
| NPI Number | 1295248425 |
|---|---|
| Provider Enumeration Date | 11/09/2017 |
| Last Update Date | 01/06/2023 |
| Certification Date | 10/05/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295248425 | NPI | - | NPPES |
| 200389800B | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 5358 (Oklahoma) | Primary |
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