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General NPI Number Information
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NPI Number | 1669758173
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Entity Type | Organization
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Legal Business Name | FRAME OF MIND COUNSELING CENTER, LLC
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Dates
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Enumeration Date | 10/28/2011
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Last Update Date | 06/17/2015
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Provider Practice Location Address
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Address Line | 516 W BROADWAY AVE
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City | ENID
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State | OK
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Zip | 73701-3842
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Country | US
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Telephone | 580-233-8900
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Fax |
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Provider Business Mailing Address
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Address Line | 516 W BROADWAY AVE
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City | ENID
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State | OK
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Zip | 73701-3842
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Country | US
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Telephone | 580-233-8900
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Fax |
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Authorized Official
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Title or Position | CO-OWNER/CEO
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Name | MS. DESIREE BOEHS SELBY
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Credential | LPC
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Telephone | 580-231-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 4389
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License Number State | OK
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