Organization
DIVINE HOLISTIC INTERVENTION SERVICES LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HENRIETTA NGOZI EVBUOMWAN M.S. LPC. (DIRECTOR)
(405) 821-8646
Entity
Organization
Contact information
Practice address
1330 N CLASSEN BLVD STE 310, OKLAHOMA CITY, OK 73106-6834
(405) 821-8646
Mailing address
1330 N CLASSEN BLVD STE 310, OKLAHOMA CITY, OK 73106-6834
(405) 821-8646
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
11/26/2018
Last updated
11/26/2018
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