Individual
SPESHIAL TYNESE WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5710 E RENO AVE STE C, MIDWEST CITY, OK 73110-2005
(405) 455-7244
(405) 455-7244
Mailing address
5710 E RENO AVE STE C, MIDWEST CITY, OK 73110-2005
(405) 455-7244
(405) 455-7292
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/12/2017
Last updated
10/12/2017
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