Organization
BLUE LOTUS COUNSELING, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DAWN MARIE BALLEW MSW, LCSW (OWNER)
(918) 458-7046
Entity
Organization
Contact information
Practice address
19216 W PETTIT BAY RD, PARK HILL, OK 74451-3010
(918) 458-7046
Mailing address
19216 W PETTIT BAY RD, PARK HILL, OK 74451-3010
(918) 458-7046
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4951
OK
Other
Enumeration date
07/13/2015
Last updated
07/29/2015
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