Organization
T.W. BOSLEY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TREBOR WELLINGTON BOSLEY M.H.R., L.P.C. (OWNER/ THERAPIST)
(405) 535-1048
Entity
Organization
Contact information
Practice address
115 S PETERS AVE, SUITE 11, NORMAN, OK 73069-6065
(405) 535-1048
Mailing address
4421 APPLE BLOSSOM CIR, MOORE, OK 73160-1007
(405) 535-1048
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4759
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003138710
PERSONAL PROVIDER NPI NUMBER
—
Enumeration date
07/18/2013
Last updated
07/18/2013
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