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Individual

DENISE EVYONNE ENGRAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4723 S ASH DR, BROKEN ARROW, OK 74011-3464
(918) 313-9602
Mailing address
4723 S ASH DR, BROKEN ARROW, OK 74011-3464
(918) 313-9602

Taxonomy

Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary

Other

Enumeration date
12/04/2014
Last updated
12/04/2014
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