Organization
OKLAHOMA MENTAL HEALTH COLLECTIVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN ROBERT DOTY LPC (OWNER)
(405) 323-0548
Entity
Organization
Contact information
Practice address
435 W. MAIN STREET, EAKLY, OK 73033
(405) 323-0548
Mailing address
PO BOX 185, EAKLY, OK 73033-0185
(405) 323-0548
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1780694778
—
OK
Enumeration date
04/20/2021
Last updated
11/19/2023
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