Provider Demographics
NPI:1023453602
Name:BISON FAMILY THERAPY INSTITUTE, PLLC
Entity type:Organization
Organization Name:BISON FAMILY THERAPY INSTITUTE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CANAAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CRANE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LMFT
Authorized Official - Phone:405-226-0644
Mailing Address - Street 1:2007 N MINNESOTA AVE
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74804-3024
Mailing Address - Country:US
Mailing Address - Phone:405-226-0644
Mailing Address - Fax:405-395-0255
Practice Address - Street 1:1601 N KICKAPOO AVE STE 900
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74804-4313
Practice Address - Country:US
Practice Address - Phone:405-585-6413
Practice Address - Fax:405-395-0255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-08
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK783106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty