Individual
EL HADJI MALICK MBODJI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3621 N KELLEY AVE, 100, OKLAHOMA CITY, OK 73111-4520
(405) 524-5525
Mailing address
12200 HERITAGE PARK RD, 279, OKLAHOMA CITY, OK 73120-5995
(405) 413-9619
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/14/2010
Last updated
07/14/2010
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