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Individual

KABLIA MOUA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5310 E 31ST ST, TULSA, OK 74135-5018
(918) 560-1399
Mailing address
10607 E 112TH PL N, OWASSO, OK 74055-4224
(559) 334-8050

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
03/17/2022
Last updated
03/17/2022
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