Organization
DESTINY CHANGERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBRA K COOK (CLINICAL DIRECTOR)
(405) 535-8838
Entity
Organization
Contact information
Practice address
6701 W WILSHIRE BLVD, OKLAHOMA CITY, OK 73132-5492
(405) 535-8838
Mailing address
6701 W WILSHIRE BLVD, OKLAHOMA CITY, OK 73132-5492
(405) 535-8838
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/20/2012
Last updated
07/20/2012
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