Individual
CECILIA MONIQUE BLACKWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3621 N KELLEY AVE, OKLAHOMA CITY, OK 73111-4520
(405) 524-5525
Mailing address
9021 SUN COUNTRY DR, MIDWEST CITY, OK 73130-3211
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
10/04/2020
Last updated
10/04/2020
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