Provider Demographics
NPI:1649593492
Name:ITS ALL RELATIVE
Entity Type:Organization
Organization Name:ITS ALL RELATIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:S
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC-LMFT
Authorized Official - Phone:405-413-2527
Mailing Address - Street 1:3604 SAGE TRAIL CIR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73179-4819
Mailing Address - Country:US
Mailing Address - Phone:405-413-2527
Mailing Address - Fax:405-418-0177
Practice Address - Street 1:3240 W BRITTON RD STE 102
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-2040
Practice Address - Country:US
Practice Address - Phone:405-413-2527
Practice Address - Fax:405-418-0177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty