Individual
STACY DIANA BANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7401 NE 23RD ST, OKLAHOMA CITY, OK 73141-1420
(214) 727-7059
Mailing address
7401 NE 23RD ST, OKLAHOMA CITY, OK 73141-1420
(405) 768-5326
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
03/06/2023
Last updated
03/06/2023
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