Individual
DEADRIAN LARAYE NOBLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1200 NE 13TH ST, OKLAHOMA CITY, OK 73117-1022
(405) 248-9368
Mailing address
1200 NE 13TH ST, OKLAHOMA CITY, OK 73117-1022
(405) 248-9368
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891061636
—
OK
Enumeration date
01/17/2021
Last updated
01/17/2021
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