Individual
OPHELIA LORENE VIEZCAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 NE 13TH ST, OKLAHOMA CITY, OK 73117-1022
(405) 719-6461
Mailing address
3036 SW 89TH ST APT F, OKLAHOMA CITY, OK 73159-6370
(405) 719-6461
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
08/07/2018
Last updated
08/07/2018
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