| Beauty For Ashes, Llc | |
|
2309 Nw 118th St Oklahoma City OK 73120-7425 | |
| (405) 303-1372 | |
| (405) 748-3924 |
| Full Name | Beauty For Ashes, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 2309 Nw 118th St, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Portia Goldsmith-nickelberry (OWNER/OPERATOR) |
| Authorized Official Contact | 4053031372 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Beauty For Ashes, Llc 2309 Nw 118th St Oklahoma City OK 73120-7425 Ph: (405) 303-1372 | Beauty For Ashes, Llc 2309 Nw 118th St Oklahoma City OK 73120-7425 Ph: (405) 303-1372 |
| NPI Number | 1134510795 |
|---|---|
| Provider Enumeration Date | 02/17/2015 |
| Last Update Date | 02/17/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134510795 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 4889 (Oklahoma) | Primary |
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