Organization
MAKING AN IMPACT COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS LAQUITA SHAREE LEWIS MSC, BHRS, CMII (EXECUTIVE DIRECTOR)
(405) 824-1871
Entity
Organization
Contact information
Practice address
3140 W BRITTON RD, SUITE 204, OKLAHOMA CITY, OK 73120-2074
(405) 608-4425
(405) 608-4428
Mailing address
3140 W BRITTON RD, SUITE 204, OKLAHOMA CITY, OK 73120-2074
(405) 608-4425
(405) 608-4428
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/04/2011
Last updated
04/04/2011
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