Organization
HEALTHY LIFE INTERVENTIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEWONE EVERETT BENNETT JR. M.S, LPC (EXECUTIVE DIRECTOR)
(405) 274-5031
Entity
Organization
Contact information
Practice address
4010 N LINCOLN BLVD, SUITE 120, OKLAHOMA CITY, OK 73105-5220
(405) 274-5031
(405) 310-1791
Mailing address
4010 N LINCOLN BLVD STE 120, OKLAHOMA CITY, OK 73105-5214
(405) 274-5031
(405) 310-1791
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4904
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200496140B
—
OK
Enumeration date
07/20/2013
Last updated
04/14/2015
About Stedi
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