Individual
CHANEL ROLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
533 N FONSHILL AVE, OKLAHOMA CITY, OK 73117-2417
(405) 830-9747
Mailing address
533 N FONSHILL AVE, OKLAHOMA CITY, OK 73117
(405) 830-9747
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/14/2011
Last updated
09/14/2011
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