Individual
CORA SPENCER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
57533 MOCCASIN TRAIL RD, PRAGUE, OK 74864-1143
(405) 567-0054
Mailing address
6004 SE 83RD PL, OKLAHOMA CITY, OK 73135-6094
(405) 887-3585
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/16/2020
Last updated
12/16/2020
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