MEDICARE: AMAYESING SKILLZ LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency		OK

General Provider Information

NPI Number	:	1669968665
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMAYESING SKILLZ LLC

Provider Business Mailing Address
First Line	:	6028 S 66TH EAST AVE STE 103
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74145-9226
Country	:	US
Telephone Number	:	918-932-8774
Fax Number	:	844-881-4140

Provider Business Practice Location Address
First Line	:	6028 S 66TH EAST AVE STE 103
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74145-9226
Country	:	US
Telephone Number	:	918-932-8774
Fax Number	:	844-881-4140

Authorized Official
Title or Position	:	CEO
Name	:	EBONY SKILLENS
Credential	:	LPC
Telephone Number	:	918-951-5084

Provider Enumeration Date	:	07/03/2018
Last Update Date	:	07/12/2024

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