Individual
AUTUMN C HOMESLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5500 N WESTERN AVE STE 142, OKLAHOMA CITY, OK 73118-4011
(405) 225-1891
Mailing address
820 W DANFORTH RD # 163, EDMOND, OK 73003-5006
(405) 313-1889
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
20261-P
OK
Other
Enumeration date
11/18/2009
Last updated
09/26/2023
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