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Individual

KATHERINE DENICE GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
12511 S SOONER ROAD PL, MOORE, OK 73165-8105
(405) 794-4647
(405) 794-8541
Mailing address
12511 S SOONER ROAD PL, MOORE, OK 73165-8105
(405) 794-4647
(405) 794-8541

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
OK

Other

Enumeration date
07/01/2022
Last updated
07/01/2022
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