Provider Demographics
NPI:1376291286
Name:U2EXCEL-N-LIFE
Entity Type:Organization
Organization Name:U2EXCEL-N-LIFE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DELORES
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC, RPT
Authorized Official - Phone:405-637-6343
Mailing Address - Street 1:11916 SILVERMOON DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-1094
Mailing Address - Country:US
Mailing Address - Phone:405-637-6343
Mailing Address - Fax:
Practice Address - Street 1:11901 N MACARTHUR BLVD STE C7
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73162-1852
Practice Address - Country:US
Practice Address - Phone:405-637-6343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-10
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health