Healthcare Provider Details

I. General information

NPI: 1003538497
Provider Name (Legal Business Name): EXHALE COUNSELING AND WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2022
Last Update Date: 09/13/2022
Certification Date: 09/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 S DENVER AVE
TULSA OK
74119-4232
US

IV. Provider business mailing address

3731 E 116TH PL S
TULSA OK
74137-8201
US

V. Phone/Fax

Practice location:
  • Phone: 918-900-1511
  • Fax:
Mailing address:
  • Phone: 918-900-1511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARCY REDDEN
Title or Position: OWNER
Credential: LPC
Phone: 918-900-1511