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Grand Lake Therapeutics Llc
Professional Counselor in Grove, Oklahoma
NPI 1528670239

Grand Lake Therapeutics Llc is a Professional Counselor based in Grove, OK and is specialized in Professional. Grand Lake Therapeutics Llc practices in Grove, OK. The NPI Number for Grand Lake Therapeutics Llc is 1528670239 and holds a License No. (Oklahoma).

The current practice location address for Grand Lake Therapeutics Llc is 1441 Lakeside Dr, Grove, OK and can be reached out via phone at 918-786-0875.

Location: 1441 Lakeside Dr, Grove, OK, 74344-4223
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1528670239
Provider Name
Grand Lake Therapeutics Llc
Credential
Provider Entity Type
Organization
Address
1441 Lakeside Dr, Grove, OK, 74344-4223
Phone Number
918-786-0875
Fax Number
Provider Enumeration Date
08/24/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1441 Lakeside Dr
City
Grove
State
Oklahoma
Zip
74344-4223
Phone Number
918-786-0875
Fax Number
person
Provider Business Mailing Address Details
Address
1441 Lakeside Dr
City
Grove
State
Oklahoma
Zip
74344-4223
Phone Number
918-786-0875
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
101YP2500X
License No.
()
Definition
Definition to come...
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