Individual
MS. LISA ANNE DECONTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1802 E COLLEGE AVE, MCALESTER, OK 74501-4276
(918) 329-0517
Mailing address
525 S 7TH ST, MCALESTER, OK 74501-5915
(918) 329-0517
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
21860
OK
Other
Enumeration date
11/29/2010
Last updated
11/29/2010
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