Individual
ROSA THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10613 KRISTIE LN, MIDWEST CITY, OK 73130-6033
(405) 706-1026
Mailing address
12109 HERITAGE PARK RD, OKLAHOMA CITY, OK 73120-9506
(405) 571-1839
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
11612
OK
Other
Enumeration date
07/19/2011
Last updated
11/13/2023
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