Individual
MRS. DEBRA S. RUPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSED, LADC UNDERSUP
Contact information
Practice address
2442 MOHAWK BLVD, TULSA, OK 74110-1519
(918) 430-0975
(918) 430-0995
Mailing address
P.O BOX 580700, TULSA, OK 74158
(918) 430-0975
(918) 430-0995
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LADC1001
OK
101YA0400X
Addiction (Substance Use Disorder) Counselor
LPC5017
OK
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104049733
—
OK
Enumeration date
09/15/2011
Last updated
09/06/2013
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