Individual
KAITLYN ELIZABETH GISSANDANER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
312 NW 119TH ST, OKLAHOMA CITY, OK 73114-7309
(405) 760-7511
Mailing address
312 NW 119TH ST, OKLAHOMA CITY, OK 73114-7309
(405) 760-7511
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
03/04/2024
Last updated
03/04/2024
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