Organization
LIFE VISION COUNSELING SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK ALLEN GONZALES L.P.C. (OWNER/ THERAPIST)
(405) 503-0490
Entity
Organization
Contact information
Practice address
3035 NW 63RD ST, 230, OKLAHOMA CITY, OK 73116-3632
(405) 242-5342
(405) 529-6972
Mailing address
3035 NW 63RD ST, 230, OKLAHOMA CITY, OK 73116-3632
(405) 242-5342
(405) 529-6972
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2458
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200306260A
—
OK
Enumeration date
09/28/2010
Last updated
03/26/2015
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