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Organization
PROGRESSIVE HEALING THERAPEUTIC PRACTICE, LLC
Active
Organization
PROGRESSIVE HEALING THERAPEUTIC PRACTICE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE MENYON ROBERSON MHR (OWNER/LICENSED PROFESSIONAL)
(918) 504-5909
Entity
Organization
Contact information
Practice address
701 W 101ST PL S, 818, JENKS, OK 74037-3505
(918) 504-5909
Mailing address
701 W 101ST PL S, 818, JENKS, OK 74037-3505
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5616
OK
Other
Enumeration date
01/06/2015
Last updated
01/06/2015
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