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Individual

ISABELLA VINYARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2206 N KICKAPOO AVE, SHAWNEE, OK 74804-2703
(405) 406-3309
Mailing address
617 N RAMBLIN OAKS DR, MOORE, OK 73160-7930
(405) 406-3309

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
05/15/2024
Last updated
04/17/2026
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