Individual
KAITLYN BIANCA MENDOZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3444 NW 19TH ST, OKLAHOMA CITY, OK 73107-3830
(405) 616-0436
Mailing address
3444 NW 19TH ST, OKLAHOMA CITY, OK 73107-3830
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OK
Other
Enumeration date
10/29/2025
Last updated
10/29/2025
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