Individual
ELICIA MANNING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7401 NE 23RD ST, OKLAHOMA CITY, OK 73141-1420
(405) 778-8007
Mailing address
10000 SE 55TH ST, OKLAHOMA CITY, OK 73150-4500
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
11/16/2016
Last updated
04/10/2023
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