Organization
OKLAHOMA COUNSELING INTERVENTION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHON SANDERS (OWNER)
(405) 613-2376
Entity
Organization
Contact information
Practice address
817 NE 63RD ST, OKLAHOMA CITY, OK 73105-6411
(405) 753-7159
Mailing address
817 NE 63RD ST, OKLAHOMA CITY, OK 73105-6411
(405) 753-7159
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
139135567
OK
Other
Enumeration date
08/27/2012
Last updated
02/27/2013
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