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Organization
BRAIN BODY SOUL THERAPY AND WELLNESS LLC
Active
Organization
BRAIN BODY SOUL THERAPY AND WELLNESS LLC
Active
Other names
Brain body soul therapy and wellness llc
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT CARSON RAYMOND LPC (PRESIDENT)
(918) 236-0833
Entity
Organization
Contact information
Practice address
2488 E 81ST ST STE 4821, TULSA, OK 74137-4290
(918) 236-0833
Mailing address
2834 E 90TH ST UNIT 1806, TULSA, OK 74137-3377
(734) 646-4354
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200946240B
—
OK
Enumeration date
07/27/2024
Last updated
08/13/2024
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