# THE BRAIN BALANCE CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205540275
- **Authorized official:** MICHAEL MAYNARD APCC (CLINICIAN)
- **Authorized official phone:** (095) 530-3207

## Contact information

- **Practice address:** 7512 N 133RD EAST AVE, OWASSO, OK 74055-7138
- **Practice address phone:** (909) 438-0351
- **Mailing address:** 7512 N 133RD EAST AVE, OWASSO, OK 74055-7138
- **Mailing address phone:** (909) 438-0351

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 01/13/2023
- **Last updated:** 01/13/2023