Individual
MRS. BREANNA R DALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD,LD
Contact information
Practice address
1125 E CLEVELAND AVE, SAPULPA, OK 74066-4641
(918) 224-9310
Mailing address
5305 S 36TH WEST AVE, TULSA, OK 74107-9538
(918) 864-3408
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2157
OK
Other
Enumeration date
04/23/2018
Last updated
04/23/2018
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