Individual
LACONIA DANIELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4721 N ELGIN AVE, TULSA, OK 74126-3215
(918) 948-0801
Mailing address
4721 N ELGIN AVE, TULSA, OK 74126-3215
(918) 948-0801
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
37H040401011
OK
372600000X
Adult Companion
37H040401011
OK
3747P1801X
Personal Care Attendant
37H040401011
OK
376K00000X
Nurse's Aide
Primary
37H040401011
OK
Other
Enumeration date
12/09/2022
Last updated
12/09/2022
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