| Good Life Enterprises, Inc. | |
|
33708 Post Office Nck Shawnee OK 74801-3407 | |
| (405) 474-3782 | |
| (888) 570-2459 |
| Full Name | Good Life Enterprises, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 33708 Post Office Nck, Shawnee, Oklahoma |
| Authorized Official Name and Position | Rebekah Lynn Wahkinney (PSYCHOLOGIST) |
| Authorized Official Contact | 4054743782 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Good Life Enterprises, Inc. 33708 Post Office Nck Shawnee OK 74801-3407 Ph: (405) 474-3782 | Good Life Enterprises, Inc. 33708 Post Office Nck Shawnee OK 74801-3407 Ph: (405) 474-3782 |
| NPI Number | 1841410776 |
|---|---|
| Provider Enumeration Date | 04/25/2007 |
| Last Update Date | 05/13/2024 |
| Certification Date | 05/13/2024 |
| Medicare PECOS PAC ID | 9931198157 |
|---|---|
| Medicare Enrollment ID | O20040511001352 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841410776 | NPI | - | NPPES |
| 200075800A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 952 (Oklahoma) | Primary |
| Provider Name | Rebekah L Wahkinney |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1750310736 PECOS PAC ID: 0648269878 Enrollment ID: I20040513000598 |
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