Individual
LEAH DIANE QUALLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1803 S WOOD DR, OKMULGEE, OK 74447-6825
(918) 756-9250
Mailing address
1803 S WOOD DR, OKMULGEE, OK 74447-6825
(918) 756-9250
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
08/31/2017
Last updated
07/21/2022
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