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Organization

G.R.A.C.E TO EVOLVE, L.L.C

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TAKENDRA HAMLIN LMSW (OWNER/THERAPIST)
(918) 407-3076
Entity
Organization

Contact information

Practice address
9410 S 92ND EAST AVE, TULSA, OK 74133-5625
(918) 407-3076
Mailing address
9410 S 92ND EAST AVE, TULSA, OK 74133-5625
(918) 407-3076

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
261QM0850X
Adult Mental Health Clinic/Center
261QM0855X
Adolescent and Children Mental Health Clinic/Center

Other

Enumeration date
01/25/2022
Last updated
01/25/2022
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