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Organization

LANAI P, PC

Active
Other names
Spring Eternal
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARIECHIA L PALMER PHD (OWNER)
(405) 623-1976
Entity
Organization

Contact information

Practice address
310 NE 28TH ST, STE. 204, OKLAHOMA CITY, OK 73105-2806
(405) 601-4565
(405) 601-4579
Mailing address
310 NE 28TH ST, STE. 204, OKLAHOMA CITY, OK 73105-2806
(405) 601-4565
(405) 601-4579

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
908
OK
106H00000X
Marriage & Family Therapist
1077
OK
251S00000X
Community/Behavioral Health Agency
Primary
908
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200491750A
OK
05
200491750B
OK
Enumeration date
03/14/2013
Last updated
03/01/2024
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