Individual
MISTY DEAHN WALKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
23 E ROSS AVE, SAPULPA, OK 74066-6423
(918) 807-1069
Mailing address
6615 S 161ST WEST AVE, SAPULPA, OK 74066-2929
(918) 807-1069
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
03/31/2022
Last updated
03/31/2022
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