Individual
DR. ERICA FENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2548 E KENOSHA ST, BROKEN ARROW, OK 74014-6712
(903) 746-7703
Mailing address
2548 E KENOSHA ST, BROKEN ARROW, OK 74014-6712
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/14/2023
Last updated
02/14/2023
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