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Individual

DEANDRA R HUNIGAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2625 N PEORIA AVE, TULSA, OK 74106-2512
(918) 749-0149
(918) 794-0196
Mailing address
2625 N PEORIA AVE, TULSA, OK 74106-2512
(918) 749-0149
(918) 794-0196

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
800673981
OK
Enumeration date
09/20/2011
Last updated
09/20/2011
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