Individual
MISS LATOYA NICHOLE WOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CASE MANAGE 1
Contact information
Practice address
4501 N CLASSEN BLVD, OKLAHOMA CITY, OK 73118-4822
(405) 968-2413
Mailing address
4501 N CLASSEN BLVD, OKLAHOMA CITY, OK 73118-4822
(405) 968-2413
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154665511
—
OK
Enumeration date
11/23/2012
Last updated
03/13/2020
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