Individual
DIETTRA YVONNE EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CBHCM
Contact information
Practice address
301 NW 63RD ST, SUITE 140, OKLAHOMA CITY, OK 73116-7907
(405) 639-2080
(405) 639-3077
Mailing address
301 NW 63RD ST, SUITE 140, OKLAHOMA CITY, OK 73116-7907
(405) 639-2080
(405) 639-3077
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
23156
OK
Other
Enumeration date
01/11/2011
Last updated
01/11/2011
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