Individual
KAYLISHA LASHAWN NEWSOME
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
26803 JOY AVE, BROKEN ARROW, OK 74014-6130
(402) 769-8741
Mailing address
26803 JOY AVE, BROKEN ARROW, OK 74014-6130
(402) 769-8741
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/13/2025
Last updated
01/13/2025
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