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1215795885
DIETMAR COLLINS
SHAWNEE, OK
NPI
1215795885
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Other Name
DJ COLLINS
Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101Y00000X Counselor
(Licence: OK 20739-P)
Enumeration Date
2024-03-08
Last Update Date
2024-03-08
Business Address
DIETMAR COLLINS
429 N UNION AVE
SHAWNEE, OK 74801-7064
Phone number: 405-275-1844
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Mailing Address
DIETMAR COLLINS
429 N UNION AVE
SHAWNEE, OK 74801-7064
Phone number: 405-275-1844
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