Individual
MARIANGELA ALTIERI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1909 W HOUSTON ST APT 4, BROKEN ARROW, OK 74012-4876
(918) 510-8453
Mailing address
1909 W HOUSTON ST APT 4, BROKEN ARROW, OK 74012-4876
(918) 510-8453
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000000000
—
OK
Enumeration date
01/29/2013
Last updated
01/29/2013
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