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General NPI Number Information
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NPI Number | 1184425753
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Entity Type | Organization
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Legal Business Name | ALLY MENTAL WELLNESS
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Dates
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Enumeration Date | 03/20/2025
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Last Update Date | 03/21/2025
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Provider Practice Location Address
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Address Line | 6421 N COLLEGE AVE
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City | OKLAHOMA CITY
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State | OK
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Zip | 73132-7209
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Country | US
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Telephone | 405-476-6573
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Fax |
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Provider Business Mailing Address
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Address Line | 6608 N WESTERN AVE # 1489
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City | OKLAHOMA CITY
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State | OK
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Zip | 73116-7326
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Country | US
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Telephone | 405-293-3962
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CENE L LIVINGSTON
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Credential | APRN, PMHNP, FNP
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Telephone | 405-476-6573
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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