Individual
DIANE ELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2820 NW 27TH ST, OKLAHOMA CITY, OK 73107-2107
(405) 623-1406
Mailing address
2820 NW 27TH ST, OKLAHOMA CITY, OK 73107-2107
(405) 623-1406
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/01/2014
Last updated
10/01/2014
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