Healthcare Provider Details

I. General information

NPI: 1275477424
Provider Name (Legal Business Name): JOURNEYS COACHING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2026
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10601 S WESTERN AVE C/O SUTRA ENTERPRISES LLC
OKLAHOMA CITY OK
73170
US

IV. Provider business mailing address

10601 S WESTERN AVE. C/O SUTRA ENTERPRISES LLC
OKLAHOMA CITY OK
73170
US

V. Phone/Fax

Practice location:
  • Phone: 405-937-1127
  • Fax:
Mailing address:
  • Phone: 405-937-1127
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name: MS. SUTRA DIANE BORGESON
Title or Position: CEO, CERT. HEALTH & NUTRITION COACH
Credential: CNC CHC ADN
Phone: 405-937-1127