Provider Demographics
NPI:1962730457
Name:TERRETT, ANGELA DAWN (LPC)
Entity type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:DAWN
Last Name:TERRETT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14700 E. 88TH PL. N. #2109
Mailing Address - Street 2:
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-4947
Mailing Address - Country:US
Mailing Address - Phone:918-399-2188
Mailing Address - Fax:918-286-7693
Practice Address - Street 1:14700 E. 88TH PL. N. #2109
Practice Address - Street 2:
Practice Address - City:OWASSO
Practice Address - State:OK
Practice Address - Zip Code:74055-4947
Practice Address - Country:US
Practice Address - Phone:918-399-2188
Practice Address - Fax:918-286-7693
Is Sole Proprietor?:No
Enumeration Date:2009-11-23
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2597101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional