Individual
MISS DACIA LANORA WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
102 N DENVER AVE, TULSA, OK 74103-1806
(918) 582-1200
(918) 560-1399
Mailing address
650 S PEORIA AVE, TULSA, OK 74120-4429
(918) 587-9471
(918) 560-1399
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
03/21/2013
Last updated
03/21/2013
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