Individual
TAHIRAH WATLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD/LD
Contact information
Practice address
12716 NE 36TH ST, SPENCER, OK 73084-9167
(405) 769-3301
(405) 769-9685
Mailing address
PO BOX 30589, MIDWEST CITY, OK 73140-3589
(405) 769-3301
(405) 769-9685
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1305
OK
Other
Enumeration date
10/25/2008
Last updated
03/11/2009
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