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General NPI Number Information
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NPI Number | 1851800825
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Entity Type | Organization
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Legal Business Name | SEYVA LLC
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Dates
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Enumeration Date | 09/21/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 8522 S 70TH E AVE
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City | TULSA
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State | OK
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Zip | 74133
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Country | US
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Telephone | 832-474-9703
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Fax |
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Provider Business Mailing Address
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Address Line | 8522 S 70TH EAST AVE
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City | TULSA
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State | OK
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Zip | 74133-5085
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Country | US
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Telephone | 832-474-9703
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Fax |
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Authorized Official
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Title or Position | LCSW
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Name | JAMI PEREIRA
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Credential | LCSW
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Telephone | 832-474-9703
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number | 4999
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License Number State | OK
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