Individual
DESTINI IRISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BHRS
Contact information
Practice address
9210 S WESTERN AVE, OKLAHOMA CITY, OK 73139-4982
(405) 512-3330
Mailing address
9210 S WESTERN AVE, OKLAHOMA CITY, OK 73139-4982
(405) 512-3330
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
01/10/2012
Last updated
08/08/2016
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