Organization
KENDRA LAUDERDALE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DOROTHY R SHOEMAKER LCDW (CREDENTIALING MANAGER)
(405) 425-0385
Entity
Organization
Contact information
Practice address
2619 N HARVEY AVE, OKLAHOMA CITY, OK 73103-3017
(405) 525-3959
Mailing address
9115 SHARTEL AVE, OKLAHOMA CITY, OK 73114-2803
(405) 605-7793
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/22/2007
Last updated
08/12/2008
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