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Organization

BEAUTY FOR ASHES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PORTIA GOLDSMITH-NICKELBERRY LCSW (OWNER/OPERATOR)
(405) 367-9034
Entity
Organization

Contact information

Practice address
849 E 33RD ST, EDMOND, OK 73013-5407
(405) 888-5299
(405) 888-5322
Mailing address
849 E 33RD ST, EDMOND, OK 73013-5407
(405) 888-5299
(405) 888-5322

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1041C0700X
Clinical Social Worker
Primary
4889
OK

Other

Enumeration date
02/17/2015
Last updated
10/30/2025
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