Individual
ROSE S. DEGENNARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
23 E ROSS AVE, SAPULPA, OK 74066-6423
(918) 227-2016
Mailing address
29408 W 341ST ST S, BRISTOW, OK 74010-4206
(970) 250-0539
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/22/2019
Last updated
08/22/2019
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