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1114124419
LISA ELLEDGE
CLEVELAND, OK
NPI
1114124419
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: OK 1742)
Enumeration Date
2007-06-29
Last Update Date
2007-07-08
Business Address
-- LISA ELLEDGE LCSW
1401 W PAWNEE ST
CLEVELAND, OK 74020-3033
Phone number: 918-358-2501
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Mailing Address
-- LISA ELLEDGE LCSW
RR 2 BOX 435G
CLEVELAND, OK 74020-9671
Phone number: 918-358-5366
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