Individual
DEADRA JANE CASSADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
407 S SOUTH AVE, PONCA CITY, OK 74601
(918) 313-5803
Mailing address
1211 S 10TH ST, BLACKWELL, OK 74631-4626
(580) 262-0195
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
08/04/2023
Last updated
08/04/2023
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