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General NPI Number Information
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NPI Number | 1568314599
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Entity Type | Organization
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Legal Business Name | CALMMALLOW LLC
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Dates
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Enumeration Date | 02/11/2026
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Last Update Date | 02/11/2026
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Provider Practice Location Address
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Address Line | 416 S MUSTANG RD STE B
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City | YUKON
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State | OK
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Zip | 73099-7314
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Country | US
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Telephone | 405-694-8678
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Fax |
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Provider Business Mailing Address
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Address Line | 2715 NW 25TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73107-2225
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CASSADIE J OGLESBY
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Credential | LPC
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Telephone | 405-694-8678
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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