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General NPI Number Information
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NPI Number | 1245544600
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Entity Type | Organization
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Legal Business Name | LUMINOUS THERAPY INC.
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Dates
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Enumeration Date | 07/27/2010
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Last Update Date | 04/10/2019
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Provider Practice Location Address
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Address Line | 3750 W. MAIN ST. SUITE 106
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City | NORMAN
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State | OK
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Zip | 73072
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Country | US
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Telephone | 405-365-3728
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Fax | 405-321-8581
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Provider Business Mailing Address
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Address Line | 3750 W. MAIN ST. SUITE 106
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City | NORMAN
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State | OK
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Zip | 73072
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Country | US
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Telephone | 405-365-3728
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Fax | 405-321-8581
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Authorized Official
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Title or Position | OWNER
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Name | AMY BETH BARTEL
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Credential | LMFT
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Telephone | 405-365-3728
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 991
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License Number State | OK
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