Innovative Community Resource Specialist
NPI #1003121724 in Oklahoma City, Oklahoma
Provider Information
- NPI Number
- 1003121724
- Entity Type
- Organization
- Organization Name
- Innovative Community Resource Specialist
- Primary Specialty
- Counselor - Professional
- Enumeration Date
- Aug 18, 2010
- Last Updated
- Dec 3, 2010
Practice Location
- Address
- 3535 NW 58TH ST STE 870E
- City
- Oklahoma City
- State
- Oklahoma
- ZIP Code
- 73112-4804
- Phone
- (405) 205-8346
Authorized Official
- Name
- LEESA LACEY, MA, LPC
- Title
- PRESIDENT
- Phone
- (405) 702-9032
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Professional — Professional |
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