Organization
THE DYSFUNCTIONAL COUCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH LOUISE MITCHELL M.ED., LPC (OWNER, THERAPIST)
(918) 638-4219
Entity
Organization
Contact information
Practice address
3839 S BOULEVARD STE 200, EDMOND, OK 73013-5495
(918) 638-4219
Mailing address
3839 S BOULEVARD STE 200, EDMOND, OK 73013-5495
(918) 638-4219
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5358
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200389800B
—
OK
Enumeration date
11/09/2017
Last updated
01/06/2023
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