Individual
MRS. LATASHA MARIE CRUIKSHANK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1300 GARLAND AVE, OKLAHOMA CITY, OK 73111-4710
(405) 637-8996
Mailing address
PO BOX 60933, OKLAHOMA CITY, OK 73146-0933
(405) 637-8996
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/26/2012
Last updated
09/26/2012
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