Provider Demographics
NPI:1598805764
Name:LIFEWORKS THERAPY SOLUTIONS INC
Entity Type:Organization
Organization Name:LIFEWORKS THERAPY SOLUTIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STACY
Authorized Official - Middle Name:
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:580-256-6100
Mailing Address - Street 1:1101 HILLCREST DR
Mailing Address - Street 2:PO BOX 308
Mailing Address - City:WOODWARD
Mailing Address - State:OK
Mailing Address - Zip Code:73801-3027
Mailing Address - Country:US
Mailing Address - Phone:580-256-6100
Mailing Address - Fax:580-256-6101
Practice Address - Street 1:1101 HILLCREST DR
Practice Address - Street 2:
Practice Address - City:WOODWARD
Practice Address - State:OK
Practice Address - Zip Code:73801-3027
Practice Address - Country:US
Practice Address - Phone:580-256-6100
Practice Address - Fax:580-256-6101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKOT459174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty