| Mindful Bison Incorporated | |
|
4330 Adams Rd Ste 100 Norman OK 73069-1007 | |
| (405) 701-8400 | |
| Not Available |
| Full Name | Mindful Bison Incorporated |
|---|---|
| Speciality | Counselor |
| Location | 4330 Adams Rd Ste 100, Norman, Oklahoma |
| Authorized Official Name and Position | Deshia Powers (PRESIDENT) |
| Authorized Official Contact | 4058207281 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindful Bison Incorporated 3325 Wood Valley Rd Norman OK 73071-3689 Ph: (405) 820-7281 | Mindful Bison Incorporated 4330 Adams Rd Ste 100 Norman OK 73069-1007 Ph: (405) 701-8400 |
| NPI Number | 1700544913 |
|---|---|
| Provider Enumeration Date | 12/05/2021 |
| Last Update Date | 12/05/2021 |
| Certification Date | 12/05/2021 |
| Medicare PECOS PAC ID | 0446601074 |
|---|---|
| Medicare Enrollment ID | O20240109000868 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700544913 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Deshia R Powers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295497592 PECOS PAC ID: 1355792987 Enrollment ID: I20240109000977 |
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