| Within The Fragments Therapy Pllc | |
|
2 E 11th St Ste 108 Edmond OK 73034-3990 | |
| (405) 850-8856 | |
| (405) 844-7232 |
| Full Name | Within The Fragments Therapy Pllc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2 E 11th St Ste 108, Edmond, Oklahoma |
| Authorized Official Name and Position | Gidget D Warner (OWNER) |
| Authorized Official Contact | 4058508856 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Within The Fragments Therapy Pllc 2 E 11th St Ste 108 Edmond OK 73034-3990 Ph: (405) 850-8856 | Within The Fragments Therapy Pllc 2 E 11th St Ste 108 Edmond OK 73034-3990 Ph: (405) 850-8856 |
| NPI Number | 1033885652 |
|---|---|
| Provider Enumeration Date | 08/23/2021 |
| Last Update Date | 08/23/2021 |
| Certification Date | 08/23/2021 |
| Medicare PECOS PAC ID | 9931581006 |
|---|---|
| Medicare Enrollment ID | O20220805001549 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033885652 | NPI | - | NPPES |
| 200370390B | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Gidget Dawn Warner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134456197 PECOS PAC ID: 0840672911 Enrollment ID: I20220805001679 |
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