Individual
DESIREE MEREDITH-MENCHACA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSW,RBT
Contact information
Practice address
107 S HIGH ST, ANTLERS, OK 74523-3818
(580) 298-2830
Mailing address
107 S HIGH ST, ANTLERS, OK 74523-3818
(580) 298-2830
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
04853943
TX
Other
Enumeration date
12/21/2016
Last updated
12/21/2016
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