Individual
DIAMOND CHA HERRING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5505 MAIN STREET, 102, DEL CITY, OK 73115
(405) 609-6595
Mailing address
5505 MAIN ST STE 102, DEL CITY, OK 73115-5508
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1
—
OK
Enumeration date
09/06/2017
Last updated
09/06/2017
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