Provider Demographics
NPI:1699452060
Name:ISRAEL, AZARAYAH JAEL-DOVE (LPC CANIDATE)
Entity type:Individual
Prefix:
First Name:AZARAYAH
Middle Name:JAEL-DOVE
Last Name:ISRAEL
Suffix:
Gender:F
Credentials:LPC CANIDATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7104 MEADOW LAKE DR
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-6033
Mailing Address - Country:US
Mailing Address - Phone:405-414-3007
Mailing Address - Fax:
Practice Address - Street 1:5909 NW EXPRESSWAY STE 232
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73132-4476
Practice Address - Country:US
Practice Address - Phone:405-414-3007
Practice Address - Fax:405-900-7167
Is Sole Proprietor?:No
Enumeration Date:2023-06-28
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional