| Dedicated Outpatient Therapy Services, Llc | |
|
920770 Deer Ridge Ln Wellston OK 74881-8146 | |
| (405) 650-7278 | |
| Not Available |
| Full Name | Dedicated Outpatient Therapy Services, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 920770 Deer Ridge Ln, Wellston, Oklahoma |
| Authorized Official Name and Position | Jill M Bashorun (OWNER) |
| Authorized Official Contact | 4056507278 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dedicated Outpatient Therapy Services, Llc 920770 Deer Ridge Ln Wellston OK 74881-8146 Ph: () - | Dedicated Outpatient Therapy Services, Llc 920770 Deer Ridge Ln Wellston OK 74881-8146 Ph: (405) 650-7278 |
| NPI Number | 1215293220 |
|---|---|
| Provider Enumeration Date | 04/03/2012 |
| Last Update Date | 04/03/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215293220 | NPI | - | NPPES |
| 100724728B | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 2206 (Oklahoma) | Primary |
Wellston Public Schools Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 800 Birch Street, Wellston, OK 74881 Phone: 405-356-2533 Fax: 405-356-2838 | |
Anna Marie Perdue, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 910785 S Gerdes Drive, Wellston, OK 74881 Phone: 405-823-4415 |