Individual
MARANDA MARIE MCMICHAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2808 NW 31ST ST, OKLAHOMA CITY, OK 73112-7407
(405) 772-6408
Mailing address
3701 E RENO AVE, OKLAHOMA CITY, OK 73117-6609
(405) 772-6408
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
10/23/2020
Last updated
10/23/2020
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