Organization
MIA BUSH, LPC-S, LADC/MH, PLLC
Active
Organization
MIA BUSH, LPC-S, LADC/MH, PLLC
Active
Other names
redMagnolia Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
MIA N BUSH (OWNER, LPC-S, LADC/MH)
(405) 446-8338
Entity
Organization
Contact information
Practice address
5009 N PENNSYLVANIA AVE, SUITE 102, OKLAHOMA CITY, OK 73112-8887
(405) 446-8338
Mailing address
5009 N PENNSYLVANIA AVE, SUITE 102, OKLAHOMA CITY, OK 73112-8887
(405) 446-8338
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
5196
OK
Other
Enumeration date
06/20/2016
Last updated
06/20/2016
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