Individual
MELISSA DAVID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CLC
Contact information
Practice address
417 WEST SAN DIEGO ST., BROKEN ARROW, OK 74011
(918) 894-1627
Mailing address
417 WEST SAN DIEGO ST., BROKEN ARROW, OK 74011
(918) 894-1627
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
240589
OK
Other
Enumeration date
05/02/2016
Last updated
05/02/2016
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