Diettra Yvonne Edwards CBHCM

NPI 1144525825 - Social Worker - 104100000X

NPI Details
NPI 1144525825
Gender Female
Enumeration Date 01/11/2011
Last Updated 01/11/2011
Entity Type Individual
Active Over 5 years ago
Practice Location
301 NW 63RD ST
SUITE 140
OKLAHOMA CITY OK, 73116-7907, US
Phone (405) 639-2080
Fax (405) 639-3077
Business Location
301 NW 63RD ST
SUITE 140
OKLAHOMA CITY OK, 73116-7907, US
Phone (405) 639-2080
Fax (405) 639-3077
Toxanomy
Taxonomy Code 104100000X
License State Oklahoma
License Number 23156
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According to our database, Diettra Yvonne Edwards CBHCM NPI is 1144525825, taxonomy code is 104100000X and license number is 23156, license state is located at Oklahoma. Diettra Yvonne Edwards CBHCM physically located at 301 Nw 63rd St, Oklahoma City OK, 73116-7907. NPI Number Diettra Yvonne Edwards CBHCM has the Individual type.

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1144525825 NPI number is provided on an as is basis without warranty of any kind. 1144525825 is maintained by the National Plan & Provider Enumeration System. The contents of Diettra Yvonne Edwards CBHCM are for informational purposes only.