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General NPI Number Information
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NPI Number | 1861233595
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Entity Type | Individual
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Provider Name | MS. LASHANDRA RENEE' CRAIG
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Gender | Female
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Dates
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Enumeration Date | 06/05/2024
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Last Update Date | 06/05/2024
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Provider Practice Location Address
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Address Line | 10802 QUAIL PLAZA DR STE 124
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City | THE VILLAGE
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State | OK
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Zip | 73120-3117
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Country | US
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Telephone | 405-843-2067
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Fax |
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Provider Business Mailing Address
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Address Line | 5004 WOODLAND PARK TER
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City | SPENCER
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State | OK
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Zip | 73084-2736
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Country | US
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Telephone | 405-250-3799
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | OK
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