Chrysalis Connection Pllc | |
1401 S Douglas Blvd Ste. A Midwest City OK 73130-5266 | |
(405) 737-2065 | |
Not Available |
Full Name | Chrysalis Connection Pllc |
---|---|
Speciality | Counselor |
Location | 1401 S Douglas Blvd, Midwest City, Oklahoma |
Authorized Official Name and Position | Nichelle D Williams (LICENSED ALCOHOL AND DRUG COUNSELOR) |
Authorized Official Contact | 4053975153 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Chrysalis Connection Pllc Po Box 271012 Oklahoma City OK 73137-1012 Ph: () - | Chrysalis Connection Pllc 1401 S Douglas Blvd Ste. A Midwest City OK 73130-5266 Ph: (405) 737-2065 |
NPI Number | 1558789750 |
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Provider Enumeration Date | 04/03/2014 |
Last Update Date | 04/03/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1558789750 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | 1036 (Oklahoma) | Primary |
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