Individual
LEILANI SKYLA YOUNGBLOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
109 N FAIRLAND ST, PRYOR, OK 74361-4205
(918) 273-1841
Mailing address
109 N FAIRLAND ST, PRYOR, OK 74361-4205
(918) 273-1841
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
01/02/2024
Last updated
01/02/2024
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