Organization
BRIDGE TO WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACY LOOKOUT (MEMBER)
(918) 949-0027
Entity
Organization
Contact information
Practice address
6706 E 136TH ST N, COLLINSVILLE, OK 74021-5774
(918) 949-0027
Mailing address
6706 E 136TH ST N, COLLINSVILLE, OK 74021-5774
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/17/2023
Last updated
10/01/2023
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