Individual
TERA LEAH BIAGGI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
11605 SOUTH Q, PONCA CITY, OK 74601
(580) 716-4787
Mailing address
11605 SOUTH Q, PONCA CITY, OK 74601
(580) 716-4787
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3696
OK
Other
Enumeration date
12/15/2008
Last updated
11/11/2009
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