Provider Demographics
NPI:1174769848
Name:DANIEL, MARK ROSS (MS, LPC)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:ROSS
Last Name:DANIEL
Suffix:
Gender:M
Credentials:MS, LPC
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Mailing Address - Street 1:2323 S HARVARD AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74114-3301
Mailing Address - Country:US
Mailing Address - Phone:918-293-2140
Mailing Address - Fax:918-712-7164
Practice Address - Street 1:2323 S HARVARD AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74114-3301
Practice Address - Country:US
Practice Address - Phone:918-293-2140
Practice Address - Fax:918-712-7164
Is Sole Proprietor?:No
Enumeration Date:2008-12-30
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK1277101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional