Individual
ELLA LORELEI FOMBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2242 NW 39TH ST, OKLAHOMA CITY, OK 73112-8884
(405) 604-5217
Mailing address
2242 NW 39TH ST, OKLAHOMA CITY, OK 73112-8884
(405) 604-5217
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
OK
Other
Enumeration date
07/12/2025
Last updated
09/16/2025
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