Individual
EBONY DAWN-COMPTON FIELDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
312 SE AVE K, IDABEL, OK 74745-5008
(580) 212-2787
Mailing address
312 SE AVE K, IDABEL, OK 74745-5008
(580) 212-2787
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
G081497136
OK
Other
Enumeration date
08/09/2024
Last updated
08/09/2024
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