| Progressive Healing Therapeutic Practice, Llc | |
|
701 W 101st Pl S 818 Jenks OK 74037-3505 | |
| (918) 504-5909 | |
| Not Available |
| Full Name | Progressive Healing Therapeutic Practice, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 701 W 101st Pl S, Jenks, Oklahoma |
| Authorized Official Name and Position | Nicole Menyon Roberson (OWNER/LICENSED PROFESSIONAL) |
| Authorized Official Contact | 9185045909 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Progressive Healing Therapeutic Practice, Llc 701 W 101st Pl S 818 Jenks OK 74037-3505 Ph: () - | Progressive Healing Therapeutic Practice, Llc 701 W 101st Pl S 818 Jenks OK 74037-3505 Ph: (918) 504-5909 |
| NPI Number | 1043608508 |
|---|---|
| Provider Enumeration Date | 01/06/2015 |
| Last Update Date | 01/06/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043608508 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 5616 (Oklahoma) | Primary |
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