Individual
GENA CRENSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, LD
Contact information
Practice address
1900 N 14TH ST, PONCA CITY, OK 74601-2035
(580) 765-0269
(580) 718-2904
Mailing address
1900 N 14TH ST, PONCA CITY, OK 74601-2035
(580) 765-0269
(580) 718-2904
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1662
OK
Other
Enumeration date
08/31/2009
Last updated
08/31/2009
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