Individual
MS. LADONNA FERN HAVEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1313 W FERGUSON AVE, BLACKWELL, OK 74631-5604
(539) 242-3322
Mailing address
1313 W FERGUSON AVE, BLACKWELL, OK 74631-5604
(539) 242-3322
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
02/16/2023
Last updated
02/16/2023
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