Individual
MARY JOSEPHINE BECERRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LD
Contact information
Practice address
744 W 9TH ST, TULSA, OK 74127-9020
(918) 599-5744
(918) 599-1763
Mailing address
744 W 9TH ST, TULSA, OK 74127-9020
(918) 599-5744
(918) 599-1763
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1355
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200054920A
—
OK
Enumeration date
01/27/2006
Last updated
11/28/2011
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