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Individual

MS. MICHELE SHANTAI DURANT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
BS

Contact information

Practice address
1900 NE 36TH ST STE G, OKLAHOMA CITY, OK 73111-5218
(405) 270-0005
Mailing address
2301 NW 122ND ST APT 3406, OKLAHOMA CITY, OK 73120-8459
(682) 622-6897

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
F083366435
OK

Other

Enumeration date
02/17/2012
Last updated
02/17/2012
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