DOMINQUE LATREACE WATHAN

SHAWNEE, OK
NPI1992349427
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Additional Taxonomies175T00000X Peer Specialist
Enumeration Date2019-10-28
Last Update Date2025-03-04
Business Address
DOMINQUE LATREACE WATHAN CMII, BHWC
111 W. 1ST ST
SHAWNEE, OK 74804-2202
Phone number: 405-273-1170
Mailing Address
DOMINQUE LATREACE WATHAN CMII, BHWC
111 W 1ST ST
CHANDLER, OK 74834-2004
Phone number: 405-273-1170
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