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Individual

LAUREN MANSOUR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CNA, CHHA, LTC

Contact information

Practice address
3517 E GILLETTE ST, BROKEN ARROW, OK 74014-8867
(191) 860-6988
Mailing address
3517 E GILLETTE ST, BROKEN ARROW, OK 74014-8867
(191) 860-6988

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
37V243121202
OK
376K00000X
Nurse's Aide
Primary
37V243111202
OK

Other

Enumeration date
05/17/2012
Last updated
05/17/2012
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