Healthcare Provider Details

I. General information

NPI: 1093523763
Provider Name (Legal Business Name): INNER KNOWING HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2024
Last Update Date: 12/26/2024
Certification Date: 12/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9249 S URBANA AVE UNIT E
TULSA OK
74137-3941
US

IV. Provider business mailing address

9249 S URBANA AVE UNIT E
TULSA OK
74137-3941
US

V. Phone/Fax

Practice location:
  • Phone: 979-966-3228
  • Fax:
Mailing address:
  • Phone: 979-966-3228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State

VIII. Authorized Official

Name: MONICA MCCAFFERTY
Title or Position: FOUNDER
Credential: CNS
Phone: 979-966-3228