Individual
LATASHIA THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
122 E EUFAULA ST, NORMAN, OK 73069-6017
(405) 447-4499
Mailing address
5912 BRANIFF DR, OKLAHOMA CITY, OK 73105-1630
(405) 204-3933
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
4106
OK
Other
Enumeration date
04/22/2010
Last updated
04/22/2010
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