Individual
ELIZABETH TOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QBHP
Contact information
Practice address
7777 E US HIGHWAY 66, EL RENO, OK 73036-9125
(405) 424-7711
Mailing address
9205 N EAGLE LN, OKLAHOMA CITY, OK 73132-1152
(479) 221-0082
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/20/2021
Last updated
10/26/2021
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