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1700122843
AHMED IDRISSA
OKLAHOMA CITY, OK
NPI
1700122843
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2012-12-18
Last Update Date
2012-12-18
Business Address
-- AHMED IDRISSA
3621 N KELLEY AVE SUITE 100
OKLAHOMA CITY, OK 73111-4520
Phone number: 405-524-5525
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Mailing Address
-- AHMED IDRISSA
3621 N KELLEY AVE SUITE 100
OKLAHOMA CITY, OK 73111-4520
Phone number: 405-524-5525
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