Provider Demographics
NPI:1285146688
Name:HARDING, GWENDOLYN IRENE
Entity type:Individual
Prefix:
First Name:GWENDOLYN
Middle Name:IRENE
Last Name:HARDING
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1506 E NEW ORLEANS PL
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74011-5139
Mailing Address - Country:US
Mailing Address - Phone:918-361-4226
Mailing Address - Fax:
Practice Address - Street 1:2488 E 81ST ST STE 485
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-4265
Practice Address - Country:US
Practice Address - Phone:918-932-1117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-25
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health