BRIDGE OF LIGHT NPI 1447904842

NPI Information

BRIDGE OF LIGHT is a mental health counselor in Oklahoma City, OK. BRIDGE OF LIGHT NPI is 1447904842. The provider is registered as an organization entity type.
The provider Other Name Is Bridge Of Light Llc.

The provider's business location address is:

14300 N PENNSYLVANIA AVE APT 326
OKLAHOMA CITY, OK
ZIP 73134-063
Phone: (405) 568-1338

The provider's authorized official is Xander Daniel Faison .
The authorized official title is Owner and has the following contact phone number (405) 568-1338.

The enumeration date for this NPI number is 2/5/2022 and was last updated on 5/3/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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