Individual
ANGELA HENSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
405 E EXCELSIOR AVE, VINITA, OK 74301-4226
(918) 256-6476
Mailing address
157 RED OAK LN, EUCHA, OK 74342-3106
(405) 696-3290
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
08/21/2023
Last updated
08/21/2023
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