Organization
THE BRAIN BALANCE CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL MAYNARD APCC (CLINICIAN)
(095) 530-3207
Entity
Organization
Contact information
Practice address
7512 N 133RD EAST AVE, OWASSO, OK 74055-7138
(909) 438-0351
Mailing address
7512 N 133RD EAST AVE, OWASSO, OK 74055-7138
(909) 438-0351
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
01/13/2023
Last updated
01/13/2023
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