Individual
MRS. DANISHA LEANN BLACKMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
5911 W MEMORIAL RD STE 100, OKLAHOMA CITY, OK 73142-2015
(405) 773-6608
Mailing address
5911 W MEMORIAL RD STE 100, OKLAHOMA CITY, OK 73142-2015
(405) 773-6608
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SUP1289
OK
Other
Enumeration date
07/16/2013
Last updated
09/26/2019
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