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Individual

FRANCES DE LEON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2001 S GARNETT RD, TULSA, OK 74128-1836
(918) 878-7877
Mailing address
4521 DIAZ AVE, FORT WORTH, TX 76107-6227
(817) 690-0527

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000000000
OK
Enumeration date
02/01/2014
Last updated
02/01/2014
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