Individual
PATRICIA ELENA SIFUENTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, MLD-C
Contact information
Practice address
14901 N PENNSYLVANIA AVE, OKLAHOMA CITY, OK 73134-6069
(918) 385-1177
Mailing address
10105 CARNIE CIR, YUKON, OK 73099-8309
(918) 385-1177
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT109063
TX
226300000X
Kinesiotherapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
810815010
LICENSED MASSAGE THERAPIST
OK
01
—
MT109063
LISENCED MASSAGE THERAPIST
TX
Enumeration date
01/27/2016
Last updated
02/21/2022
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