| Restore Behavioral Health Llc | |
|
2212 Westpark Dr Ste 105 Norman OK 73069-4098 | |
| (405) 919-1817 | |
| Not Available |
| Full Name | Restore Behavioral Health Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2212 Westpark Dr Ste 105, Norman, Oklahoma |
| Authorized Official Name and Position | Gina Lynn Dixon (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 4059191817 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Restore Behavioral Health Llc 1008 24th Ave Nw Norman OK 73069-6369 Ph: (405) 919-1817 | Restore Behavioral Health Llc 2212 Westpark Dr Ste 105 Norman OK 73069-4098 Ph: (405) 919-1817 |
| NPI Number | 1083163083 |
|---|---|
| Provider Enumeration Date | 10/02/2016 |
| Last Update Date | 05/20/2024 |
| Certification Date | 05/20/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083163083 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 5274 (Oklahoma) | Primary |
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