Individual
DESTINI JAMAE UTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1521 HWY 54 NE, GUYMON, OK 73942-3156
(580) 338-5851
Mailing address
1521 HWY 54 NE, GUYMON, OK 73942-3156
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/21/2020
Last updated
05/21/2020
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