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Individual

DELISA HERBERT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2401 NW 122ND ST APT 193, OKLAHOMA CITY, OK 73120-8469
(405) 923-8072
Mailing address
2401 NW 122ND ST, APT 193, OKLAHOMA CITY, OK 73120-8493
(405) 923-8072

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
S081702012
OK

Other

Enumeration date
08/22/2016
Last updated
08/22/2016
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