Individual
MISS ELIZABETH AYALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1719 SW 11TH ST, LAWTON, OK 73501-7305
(580) 581-1818
Mailing address
1719 SW 11TH ST, LAWTON, OK 73501-7305
(580) 581-1818
Taxonomy
Speciality
Code
Description
License number
State
103TR0400X
Rehabilitation Psychologist
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
08/28/2012
Last updated
01/15/2013
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