Bridge Of Light Llc | |
14300 N Pennsylvania Ave Apt 326 Oklahoma City OK 73134-6063 | |
(405) 568-1338 | |
Not Available |
Full Name | Bridge Of Light Llc |
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Speciality | Counselor - Mental Health |
Location | 14300 N Pennsylvania Ave Apt 326, Oklahoma City, Oklahoma |
Authorized Official Name and Position | Xander Daniel Faison (OWNER) |
Authorized Official Contact | 4055681338 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Bridge Of Light Llc 14300 N Pennsylvania Ave Apt 326 Oklahoma City OK 73134-6063 Ph: (405) 568-1338 | Bridge Of Light Llc 14300 N Pennsylvania Ave Apt 326 Oklahoma City OK 73134-6063 Ph: (405) 568-1338 |
NPI Number | 1447904842 |
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Provider Enumeration Date | 02/05/2022 |
Last Update Date | 05/03/2022 |
Certification Date | 05/03/2022 |
Identifier | Type | State | Issuer |
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1447904842 | NPI | - | NPPES |
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