Provider Demographics
NPI:1750530002
Name:OVERTURF, HEATHER NICOLE
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:NICOLE
Last Name:OVERTURF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12016 REMINGTON RD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73170-4854
Mailing Address - Country:US
Mailing Address - Phone:405-833-3999
Mailing Address - Fax:
Practice Address - Street 1:804 W CHOCTAW AVE
Practice Address - Street 2:
Practice Address - City:CHICKASHA
Practice Address - State:OK
Practice Address - Zip Code:73018-2310
Practice Address - Country:US
Practice Address - Phone:405-833-3999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-11
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health