Organization
PRIME MENTAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE RUDESILL LPC, CRC (OWNER)
(405) 456-9688
Entity
Organization
Contact information
Practice address
6001 NW 63RD ST # 32424, OKLAHOMA CITY, OK 73132-7504
(405) 456-9688
Mailing address
PO BOX 32424, OKLAHOMA CITY, OK 73123-0624
(405) 456-9688
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
225C00000X
Rehabilitation Counselor
—
—
Other
Enumeration date
01/19/2023
Last updated
01/19/2023
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