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SANDRA V WALLACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
909 ALAMEDA ST, NORMAN, OK 73071-5229
(405) 573-3909
(405) 573-3966
Mailing address
1628 ORIOLE DR, NORMAN, OK 73071-6127
(405) 321-7610

Taxonomy

Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
R0047895 D6361633
OK

Other

Enumeration date
04/02/2007
Last updated
07/08/2007
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