Individual
MISTI J LEYVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD/LD
Contact information
Practice address
825 NE 10TH ST, OUPB 4300, OKLAHOMA CITY, OK 73104-5417
(405) 271-3050
Mailing address
1122 NE 13TH ST, ORI-236, OKLAHOMA CITY, OK 73117-1039
(405) 271-1515
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1219
OK
Other
Enumeration date
03/02/2012
Last updated
03/02/2012
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