Individual
MR. ALEXIS HEATRICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1330 N CLASSEN BLVD, SUITRE 214, OKLAHOMA CITY, OK 73106
(405) 601-6710
Mailing address
605 NW 117TH ST, OKLAHOMA CITY, OK 73114-7922
(405) 205-7813
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
—
—
Other
Enumeration date
09/04/2012
Last updated
09/04/2012
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