Individual
ANGELA WELLIVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6510 S WESTERN AVE, OKLAHOMA CITY, OK 73139-1712
(405) 634-1497
Mailing address
2733 NW 162ND ST, EDMOND, OK 73013-1235
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/29/2022
Last updated
08/29/2022
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