Individual
AMANDA CADDELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
616 NW 21ST ST, OKLAHOMA CITY, OK 73103-1810
(405) 528-7724
(405) 208-4079
Mailing address
616 NW 21ST ST, OKLAHOMA CITY, OK 73103-1810
(405) 528-7724
(405) 208-4079
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
22530
OK
Other
Enumeration date
10/17/2012
Last updated
10/17/2012
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