Organization
EMBRACE LIFE COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY PETTY LPC (LPC AND OWNER)
(918) 212-6196
Entity
Organization
Contact information
Practice address
10306 N 138TH EAST AVE STE 206, OWASSO, OK 74055-4679
(918) 212-6196
(918) 520-1202
Mailing address
10306 N 138TH EAST AVE STE 206, OWASSO, OK 74055-4679
(918) 212-6196
(918) 520-1202
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5565
OK
Other
Enumeration date
08/15/2018
Last updated
08/15/2018
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