Individual
LATISHA D WOODFORK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MHR, LPC CANDIDATE
Contact information
Practice address
1801 23RD AVE SE, NORMAN, OK 73071-1066
(918) 605-5586
Mailing address
2005 SE 7TH CT, MOORE, OK 73160-8395
(918) 605-5586
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
05/18/2020
Last updated
08/09/2022
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