Individual
MACHELLE FRANCES RENFRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6333 E SKELLY DR, TULSA, OK 74135-6106
(918) 664-4224
Mailing address
3821 S ROLLING OAKS DR, TULSA, OK 74107-4872
(539) 250-8704
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
082777404
DRIVERS LICENSE
OK
05
—
082777404
—
OK
05
—
M082777404
—
OK
Enumeration date
02/02/2023
Last updated
02/02/2023
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