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Individual

DEBORA RUTH MAZAHERI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS

Contact information

Practice address
3445 W MEMORIAL RD STE I, OKLAHOMA CITY, OK 73134-7001
(405) 748-6292
(405) 748-6292
Mailing address
PO BOX 720360, OKLAHOMA CITY, OK 73172-0360
(405) 748-6292
(405) 748-6293

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
104
OK
101YP2500X
Professional Counselor
804
OK
106H00000X
Marriage & Family Therapist
653
OK

Other

Enumeration date
06/07/2007
Last updated
06/06/2008
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