Provider Demographics
NPI:1174755268
Name:BOHANAN, HARRIET ANN (LPC)
Entity type:Individual
Prefix:MS
First Name:HARRIET
Middle Name:ANN
Last Name:BOHANAN
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 1:2812 DALEWOOD PL
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-4710
Mailing Address - Country:US
Mailing Address - Phone:405-213-7598
Mailing Address - Fax:
Practice Address - Street 1:3625 W MAIN ST
Practice Address - Street 2:SUITE 100
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-4656
Practice Address - Country:US
Practice Address - Phone:405-579-7563
Practice Address - Fax:405-579-7560
Is Sole Proprietor?:No
Enumeration Date:2009-08-22
Last Update Date:2009-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4220101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor