Organization
HEARTROOT CLINICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDYN WILLIS LPC (PSYCHOTHERAPIST)
(918) 212-6112
Entity
Organization
Contact information
Practice address
6726 E 93RD ST, TULSA, OK 74133-5321
(918) 212-6112
Mailing address
6726 E 93RD ST, TULSA, OK 74133-5321
(918) 212-6112
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/27/2025
Last updated
03/27/2025
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