Individual
HEATHER KONICHEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3801 NW 63RD ST BLDG 1, OKLAHOMA CITY, OK 73116-1900
(405) 608-6077
Mailing address
3801 NW 63RD ST BLDG 1, OKLAHOMA CITY, OK 73116-1900
(405) 608-6077
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OK
Other
Enumeration date
02/09/2021
Last updated
04/05/2022
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