| Lasting Change Therapy Llc | |
|
10600 S Penn Ave Ste 16-915 Oklahoma City OK 73170-4256 | |
| (405) 237-5782 | |
| Not Available |
| Full Name | Lasting Change Therapy Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 10600 S Penn Ave Ste 16-915, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Thai-an Truong (OWNER) |
| Authorized Official Contact | 4052375782 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lasting Change Therapy Llc 10600 S Penn Ave Ste 16-915 Oklahoma City OK 73170-4256 Ph: (405) 237-5782 | Lasting Change Therapy Llc 10600 S Penn Ave Ste 16-915 Oklahoma City OK 73170-4256 Ph: (405) 237-5782 |
| NPI Number | 1639699267 |
|---|---|
| Provider Enumeration Date | 06/24/2017 |
| Last Update Date | 01/02/2023 |
| Certification Date | 01/02/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639699267 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 4691 (Oklahoma) | Primary |
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