Individual
AJASHA IRENE DEMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.B.
Contact information
Practice address
614 E 141ST PL, GLENPOOL, OK 74033-3624
(918) 759-7472
Mailing address
614 E 141ST PL, GLENPOOL, OK 74033-3624
(918) 759-7472
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
03/19/2024
Last updated
03/19/2024
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