Individual
ANDREA LOFTIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
620 NW 5TH ST STE D, MOORE, OK 73160-3947
(405) 208-4469
Mailing address
401 LISA ST APT 204, RINCON, GA 31326-9602
(912) 656-6007
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
7456
OK
101YM0800X
Mental Health Counselor
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/12/2014
Last updated
01/11/2023
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