Provider Demographics
NPI:1114638780
Name:SILOAM TRAUMA & WELLNESS SOLUTIONS CENTER
Entity Type:Organization
Organization Name:SILOAM TRAUMA & WELLNESS SOLUTIONS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LICENSED THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRASHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:CUFFY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:918-921-4271
Mailing Address - Street 1:PO BOX 33381
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74153-3381
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:31609 E 64TH ST S
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74014-8583
Practice Address - Country:US
Practice Address - Phone:918-921-4271
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty