Individual
KRISTEN WAYMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
104 W GULFPORT ST, BROKEN ARROW, OK 74011-5022
(504) 310-5763
Mailing address
104 W GULFPORT ST, BROKEN ARROW, OK 74011-5022
(504) 310-5763
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
—
OK
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
05/06/2019
Last updated
05/06/2019
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