Individual
MRS. ELIZABETH ANN SAMPLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
101 W BOSTON ST, BROKEN ARROW, OK 74012-7014
(918) 402-3897
Mailing address
101 W BOSTON ST, BROKEN ARROW, OK 74012-7014
(918) 402-3897
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/14/2011
Last updated
07/14/2011
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