Individual
LIA EK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5331 E 124TH PL S, BIXBY, OK 74008-5822
(918) 236-6298
Mailing address
5331 E 124TH PL S, BIXBY, OK 74008-5822
(530) 786-9589
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
09/17/2014
Last updated
03/30/2025
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