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Organization
DIVINE HOLISTIC INTERVENTION SERVICES LLC.
Active
Organization
DIVINE HOLISTIC INTERVENTION SERVICES LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HENRIETTA NGOZI EVBUOMWAN M.S. LPC. (DIRECTOR)
(405) 821-8646
Entity
Organization
Contact information
Practice address
1330 N CLASSEN BLVD STE 310, OKLAHOMA CITY, OK 73106-6834
(405) 821-8646
Mailing address
1330 N CLASSEN BLVD STE 310, OKLAHOMA CITY, OK 73106-6834
(405) 821-8646
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
11/26/2018
Last updated
11/26/2018
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