| Grace Therapy, Inc. | |
|
4870 S Lewis Ave Suite 190 Tulsa OK 74105-5151 | |
| (918) 869-5544 | |
| Not Available |
| Full Name | Grace Therapy, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4870 S Lewis Ave, Tulsa, Oklahoma |
| Authorized Official Name and Position | Mylinda Renee Fanj (MENTAL HEALTH PROFESSIONAL) |
| Authorized Official Contact | 9188695544 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grace Therapy, Inc. 4870 S Lewis Ave Suite 190 Tulsa OK 74105-5151 Ph: (918) 869-5544 | Grace Therapy, Inc. 4870 S Lewis Ave Suite 190 Tulsa OK 74105-5151 Ph: (918) 869-5544 |
| NPI Number | 1639537970 |
|---|---|
| Provider Enumeration Date | 02/01/2016 |
| Last Update Date | 02/01/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639537970 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 4921 (Oklahoma) | Primary |
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