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Individual

LATRITA MARIE MCFADDEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
B.S.

Contact information

Practice address
9904 GEORGIA AVE, OKLAHOMA CITY, OK 73120-4029
(918) 304-9853
(406) 463-5755
Mailing address
9904 GEORGIA AVE, OKLAHOMA CITY, OK 73120-4029
(918) 304-9853
(406) 463-5755

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100734620B
OK
05
100734620D
OK
Enumeration date
10/04/2006
Last updated
06/09/2011
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