Individual
MS. LISETTE CAVENY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CM-A
Contact information
Practice address
109 S HARRILL AVE, WAGONER, OK 74467-5317
(918) 485-3554
(918) 485-8371
Mailing address
1001 S MCKINLEY AVE, WAGONER, OK 74467-7231
(918) 798-0555
(918) 485-3554
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/30/2007
Last updated
07/08/2007
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