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Contact Information

BRAINSTORM PSYCHOLOGICAL SERVICES, PLLC
215 S MUSKOGEE AVE
TAHLEQUAH, OK74464-3658
 Phone: 918-216-0162
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
 

Clinical Child & Adolescent

103TC2200X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for BRAINSTORM PSYCHOLOGICAL SERVICES PLLC · (Female)

NPI # 1699506725
Status Active
Credentials
Entity Individual
Enumeration date 08/10/2024
Last updated 08/10/2024 - More than a year ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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