Individual
MISS LATASHA RIDEAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPRSS
Contact information
Practice address
10326 GREENBRIAR PKWY, OKLAHOMA CITY, OK 73159-7643
(405) 759-3860
Mailing address
5905 SE 68TH ST, OKLAHOMA CITY, OK 73135-1911
(405) 822-1754
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/12/2020
Last updated
03/12/2020
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