Individual
ALISHA MIRANDA DEFRANGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BHCM II
Contact information
Practice address
706 SOUTH GREATHOUSE DRIVE, ATOKA, OK 74525
(580) 889-3424
(580) 889-4050
Mailing address
P.O. BOX 720, ATOKA, OK 74525
(580) 889-3424
(580) 889-4050
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
OK
175T00000X
Peer Specialist
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
73-1311206
—
OK
Enumeration date
06/18/2015
Last updated
05/10/2024
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