Individual
TERA BETH WINDHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD LD
Contact information
Practice address
100 S BLISS AVE, TAHLEQUAH, OK 74464-2512
(918) 458-3100
Mailing address
100 S BLISS AVE, TAHLEQUAH, OK 74464-2512
(918) 458-3100
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1389
OK
Other
Enumeration date
12/13/2006
Last updated
07/09/2007
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