Individual
ALYSSA FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
429 N UNION AVE, SHAWNEE, OK 74801-7064
(316) 621-1081
Mailing address
429 N UNION AVE, SHAWNEE, OK 74801-7064
(316) 621-1081
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/16/2023
Last updated
06/16/2023
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