Individual
MISS BRIANNA LEIALOHA WISBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
19320 E ADMIRAL PL STE B, CATOOSA, OK 74015-3240
(918) 340-2080
(918) 342-0075
Mailing address
19320 E ADMIRAL PL STE B, CATOOSA, OK 74015-3240
(918) 340-2080
(918) 342-0075
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/26/2023
Last updated
08/23/2023
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