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Individual

ANITA BERRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5105 TINKER RD, OKLAHOMA CITY, OK 73135-5069
(405) 923-4193
Mailing address
5105 TINKER RD, OKLAHOMA CITY, OK 73135-5069
(405) 923-4193

Taxonomy

Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00000
NONE
Enumeration date
04/23/2021
Last updated
04/23/2021
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