| Innova Recovery, Pllc | |
|
2524 N Broadway # 563 Edmond OK 73034-4172 | |
| (210) 254-3618 | |
| (210) 881-9022 |
| Full Name | Innova Recovery, Pllc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 2524 N Broadway # 563, Edmond, Oklahoma |
| Authorized Official Name and Position | Kasi Howard (OWNER) |
| Authorized Official Contact | 2102543618 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Innova Recovery, Pllc 3502 Paesanos Pkwy Ste 101 San Antonio TX 78231-1297 Ph: (210) 254-3618 | Innova Recovery, Pllc 2524 N Broadway # 563 Edmond OK 73034-4172 Ph: (210) 254-3618 |
| NPI Number | 1497598684 |
|---|---|
| Provider Enumeration Date | 06/15/2024 |
| Last Update Date | 06/15/2024 |
| Certification Date | 06/14/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497598684 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
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