Provider Demographics
NPI:1982613964
Name:EPPERLY, ANDRA R (LPC, NCC)
Entity type:Individual
Prefix:MRS
First Name:ANDRA
Middle Name:R
Last Name:EPPERLY
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 643
Mailing Address - Street 2:2701 1/2 E. MAIN
Mailing Address - City:WEATHERFORD
Mailing Address - State:OK
Mailing Address - Zip Code:73096-0643
Mailing Address - Country:US
Mailing Address - Phone:580-774-2833
Mailing Address - Fax:580-774-2803
Practice Address - Street 1:2701 1/2 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:OK
Practice Address - Zip Code:73096-2641
Practice Address - Country:US
Practice Address - Phone:580-774-2833
Practice Address - Fax:580-774-2803
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1545101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional