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General NPI Number Information
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NPI Number | 1871779231
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Entity Type | Organization
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Legal Business Name | REAL SOULUTIONS CHRISTIAN COUNSELING, INC
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Dates
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Enumeration Date | 01/16/2008
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Last Update Date | 09/14/2011
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Provider Practice Location Address
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Address Line | 1831 E. 71ST STREET SUITE 256
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City | TULSA
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State | OK
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Zip | 74136
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Country | US
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Telephone | 918-877-2723
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Fax |
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Provider Business Mailing Address
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Address Line | 1831 E. 71ST STREET SUITE 256
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City | TULSA
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State | OK
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Zip | 74136
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Country | US
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Telephone | 918-877-2723
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/FOUNDER
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Name | MS. JAYNE ALBERTA BOWMAN
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Credential | LPC, BCPC
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Telephone | 918-289-7827
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 3030
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License Number State | OK
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