Healthcare Provider Details

I. General information

NPI: 1962277830
Provider Name (Legal Business Name): ALPHA & OMEGA THERAPY AND DOULA SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2023
Last Update Date: 11/20/2023
Certification Date: 11/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25211 E 64TH ST S
BROKEN ARROW OK
74014-2214
US

IV. Provider business mailing address

25211 E 64TH ST S
BROKEN ARROW OK
74014-2214
US

V. Phone/Fax

Practice location:
  • Phone: 918-812-5315
  • Fax:
Mailing address:
  • Phone: 918-812-5315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name: KATHLEEN ANN BILLIPS
Title or Position: DIRECTOR
Credential: MS, LBP
Phone: 918-812-5315