Individual
DANIEL ROBERT MENDOZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3838 NW 36TH ST, OKLAHOMA CITY, OK 73112-2970
(405) 702-9032
Mailing address
2510 LAKECREST DR, MOORE, OK 73170-7475
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/22/2019
Last updated
04/22/2019
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