Individual
LEA ANN IANNUCCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10401 HOLLYHEAD WAY, YUKON, OK 73099-7516
(405) 577-2804
Mailing address
10401 HOLLYHEAD WAY, YUKON, OK 73099-7516
(405) 577-2804
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/04/2007
Last updated
09/04/2007
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