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Organization

MIND SPA LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SARAH E LAND D.O. (OWNER/MIND SPA LLC)
(918) 591-2510
Entity
Organization

Contact information

Practice address
7302 S YALE AVE, TULSA, OK 74136-7027
(918) 591-2510
(918) 591-2511
Mailing address
7302 S YALE AVE, TULSA, OK 74136-7027
(918) 591-2510
(918) 591-2511

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
2641
OK
164W00000X
Licensed Practical Nurse
63489
OK
2084P0800X
Psychiatry Physician
Primary
4200
OK
363LP0808X
Psychiatric/Mental Health Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200060070A
OK
05
200225500A
OK
Enumeration date
01/08/2009
Last updated
09/30/2022
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