Healthcare Provider Details

I. General information

NPI: 1649593922
Provider Name (Legal Business Name): SILENT LION INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2010
Last Update Date: 03/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7901 NW 16TH ST
OKLAHOMA CITY OK
73127-3107
US

IV. Provider business mailing address

7901 NW 16TH ST
OKLAHOMA CITY OK
73127-3107
US

V. Phone/Fax

Practice location:
  • Phone: 405-787-2042
  • Fax: 405-787-2042
Mailing address:
  • Phone: 405-787-2042
  • Fax: 405-787-2042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number940
License Number StateOK

VIII. Authorized Official

Name: MR. DANIEL KEVIN PLAMER
Title or Position: OFFICER
Credential: M.H.R., LMFT
Phone: 405-503-5039