Organization
BRAINSTORM PSYCHOLOGICAL SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTI VELEZ PSYD (CLINICAL PSYCHOLOGIST)
(918) 808-9084
Entity
Organization
Contact information
Practice address
215 S MUSKOGEE AVE, TAHLEQUAH, OK 74464-3658
(918) 216-0162
Mailing address
3871 LEXINGTON AVE, TAHLEQUAH, OK 74464-5056
(918) 808-9084
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
Other
Enumeration date
08/10/2024
Last updated
08/10/2024
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