Afresh Mind LLC
Organization Active NPI Professional Counselor · Bixby, OK
NPI 1104661941 · NPPES record last updated Jun 25, 2024
Key facts
- NPI
- 1104661941
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Professional Counselor 101YP2500X
- Legal business name
- AFRESH MIND LLC
- Practice address
- 7643 E 126TH St S Ste 217D
Bixby, OK 74008-2988 - Phone
- (918) 280-9098
- NPI assigned
- Jun 25, 2024
- Organization subpart
- No
Authorized official
- Name
- Laqueta Jackson
- Title
- Owner
- Phone
- (918) 280-9098
Practitioners 1
National Provider Directory
Locations
7643 E 126th St S
Ste 217D
Bixby, OK 74008
Phone (918) 280-9098
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor |
101YP2500X | Yes |
Addresses
Primary practice location
7643 E 126TH St S Ste 217D
Bixby, OK 74008-2988
Mailing address
7643 E 126TH St S Ste 217D
Bixby, OK 74008-2988
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All providers in Bixby, OK · Professional Counselor in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 25, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.