Individual
LARA DUKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
610 S HIAWATHA ST, SAPULPA, OK 74066-4650
(918) 248-5026
Mailing address
610 S HIAWATHA ST, SAPULPA, OK 74066-4650
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1075
OK
Other
Enumeration date
03/03/2013
Last updated
03/03/2013
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