| Pinky Promise Keepers Pllc | |
|
5710 E Reno Ave # C Midwest City OK 73110-2005 | |
| (405) 455-7244 | |
| (405) 455-7292 |
| Full Name | Pinky Promise Keepers Pllc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 5710 E Reno Ave # C, Midwest City, Oklahoma |
| Authorized Official Name and Position | Luquetta Mcclarty (CLINICAL DIRECTOR) |
| Authorized Official Contact | 4054557244 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pinky Promise Keepers Pllc 5710 E Reno Ave Ste C Midwest City OK 73110-2005 Ph: (405) 455-7244 | Pinky Promise Keepers Pllc 5710 E Reno Ave # C Midwest City OK 73110-2005 Ph: (405) 455-7244 |
| NPI Number | 1770164329 |
|---|---|
| Provider Enumeration Date | 04/15/2021 |
| Last Update Date | 04/15/2021 |
| Certification Date | 04/15/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770164329 | NPI | - | NPPES |
| 1487972444 | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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