Provider Demographics
NPI:1417492752
Name:WELLNESS AND THERAPY SERVICES, LLC
Entity Type:Organization
Organization Name:WELLNESS AND THERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BROOKE
Authorized Official - Middle Name:
Authorized Official - Last Name:PEYTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-216-4821
Mailing Address - Street 1:2301 W I 44 SERVICE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-8729
Mailing Address - Country:US
Mailing Address - Phone:405-924-0354
Mailing Address - Fax:
Practice Address - Street 1:2301 W I 44 SERVICE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-8729
Practice Address - Country:US
Practice Address - Phone:405-924-0354
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-22
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Single Specialty