Organization
FULL SAIL BEHAVIORAL HEALTH COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA SUE UPTON LPC (OWNER/OPERATOR)
(918) 284-5658
Entity
Organization
Contact information
Practice address
3602 N UNION AVE, SHAWNEE, OK 74804-2158
(918) 284-5658
Mailing address
3602 N UNION AVE, SHAWNEE, OK 74804-2158
(918) 284-5658
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
03/02/2020
Last updated
03/02/2020
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