Individual
ALYSSA CHILDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1640 W KEETOOWAH ST, TAHLEQUAH, OK 74464-3497
(918) 708-9009
Mailing address
1640 W KEETOOWAH ST, TAHLEQUAH, OK 74464-3497
(918) 708-9009
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
09/28/2023
Last updated
10/10/2023
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