Provider Demographics
NPI:1770816217
Name:VESELY, LAUREN MACKENZIE
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:MACKENZIE
Last Name:VESELY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RESOURCE MANAGEMENT
Mailing Address - Street 2:1300 HOPPE BLVD., SUITE 1
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74820
Mailing Address - Country:US
Mailing Address - Phone:580-436-7211
Mailing Address - Fax:580-272-5757
Practice Address - Street 1:3115 E. ARLINGTON BLVD.
Practice Address - Street 2:HEALTHY LIFESTYLES
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820
Practice Address - Country:US
Practice Address - Phone:580-332-6345
Practice Address - Fax:580-421-7724
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-16
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health