Organization
DEDICATED OUTPATIENT THERAPY SERVICES, LLC
Active
Other names
D.O.T.S., LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JILL M BASHORUN LPC (OWNER)
(405) 650-7278
Entity
Organization
Contact information
Practice address
920770 DEER RIDGE LN, WELLSTON, OK 74881-8146
(405) 650-7278
Mailing address
920770 DEER RIDGE LN, WELLSTON, OK 74881-8146
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2206
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100724728B
—
OK
Enumeration date
04/03/2012
Last updated
04/03/2012
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