Individual
ANGELA PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
745 NE 81ST ST, OKLAHOMA CITY, OK 73114-4001
(405) 889-6038
Mailing address
745 NE 81ST ST, OKLAHOMA CITY, OK 73114-4001
(405) 889-6038
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
02/24/2020
Last updated
02/24/2020
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