Provider Demographics
NPI:1730070541
Name:HUERTA, ANGEL (MS)
Entity type:Individual
Prefix:MS
First Name:ANGEL
Middle Name:
Last Name:HUERTA
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3602 N WASHINGTON ST APT I85
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74075-1327
Mailing Address - Country:US
Mailing Address - Phone:915-274-8297
Mailing Address - Fax:
Practice Address - Street 1:15 W 6TH ST STE 1211
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74119-5406
Practice Address - Country:US
Practice Address - Phone:918-295-5055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-10
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKLPCCANDIDATE12832101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health