Provider Demographics
NPI:1043721574
Name:TULSA DIALECTICAL BEHAVIOR THERAPY LLC
Entity type:Organization
Organization Name:TULSA DIALECTICAL BEHAVIOR THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:BYLER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:479-601-4446
Mailing Address - Street 1:3010 S HARVARD AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74114-6126
Mailing Address - Country:US
Mailing Address - Phone:918-982-6150
Mailing Address - Fax:918-982-6101
Practice Address - Street 1:3010 S HARVARD AVE STE 306
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74114-6140
Practice Address - Country:US
Practice Address - Phone:918-982-6150
Practice Address - Fax:918-982-6101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-24
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty