Blue Heaven Therapy, L.l.c.

NPI #1750050217 in Seminole, Oklahoma

Provider Information

NPI Number: 1750050217
Entity Type: Organization
Organization Name: Blue Heaven Therapy, L.l.c.
Primary Specialty: Counselor - Professional
Enumeration Date: Sep 8, 2021
Last Updated: Sep 10, 2021

Practice Location

Address: 400 TIMMONS ST.
City: Seminole
State: Oklahoma
ZIP Code: 74868
Phone: (405) 220-7165

Authorized Official

Name: JENNIFER L CHEATHAM, MSPS, LPC
Title: DIRECTOR
Phone: (405) 220-7165

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Professional — Professional	101YP2500X	Primary

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