Individual
VIOLA DALLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC UNDER SUPERVISI
Contact information
Practice address
920 S BOULEVARD, SUITE #103, EDMOND, OK 73034-4731
(405) 406-4803
Mailing address
920 S BOULEVARD, SUITE 103, EDMOND, OK 73034-4731
(405) 406-4803
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/06/2009
Last updated
11/11/2010
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