| The Griffin Promise | |
|
2552 E Kenosha St Broken Arrow OK 74014-6712 | |
| (918) 893-3735 | |
| (918) 893-3745 |
| Full Name | The Griffin Promise |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2552 E Kenosha St, Broken Arrow, Oklahoma |
| Authorized Official Name and Position | Lori Frederick (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9188933735 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Griffin Promise 2552 E Kenosha St Broken Arrow OK 74014-6712 Ph: (918) 893-3735 | The Griffin Promise 2552 E Kenosha St Broken Arrow OK 74014-6712 Ph: (918) 893-3735 |
| NPI Number | 1881108975 |
|---|---|
| Provider Enumeration Date | 11/28/2017 |
| Last Update Date | 11/28/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881108975 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 1239 (Oklahoma) | Primary |
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