Provider Demographics
NPI:1124296041
Name:DURAN, ABBY MARIE JAMISON (LPC- UNDER SUPERVISI)
Entity type:Individual
Prefix:MRS
First Name:ABBY
Middle Name:MARIE JAMISON
Last Name:DURAN
Suffix:
Gender:F
Credentials:LPC- UNDER SUPERVISI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7113 E HASKELL PL
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74115-7826
Mailing Address - Country:US
Mailing Address - Phone:918-409-5458
Mailing Address - Fax:
Practice Address - Street 1:23 E. ROSS
Practice Address - Street 2:
Practice Address - City:SAPUPLA
Practice Address - State:OK
Practice Address - Zip Code:74066
Practice Address - Country:US
Practice Address - Phone:918-227-2016
Practice Address - Fax:918-227-2016
Is Sole Proprietor?:No
Enumeration Date:2008-02-13
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor