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1932870821
LATASHA NICOLE BERRY
PONCA CITY, OK
NPI
1932870821
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2021-09-22
Last Update Date
2021-09-22
Business Address
LATASHA NICOLE BERRY
827 E HUBBARD RD
PONCA CITY, OK 74601-1073
Phone number: 620-446-2454
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Mailing Address
LATASHA NICOLE BERRY
827 E HUBBARD RD
PONCA CITY, OK 74601-1073
Phone number: 620-446-2454
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