Willis, Lakesha

Willis, Lakesha is an individual health care provider with primary practice located at 3015 E Skelly Dr , Tulsa OK 74105-6317. She recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as her primary health care specialty. Willis, Lakesha can be contacted via phone (918) 712-0859.

Contact Information

Primary practice address
3015 E Skelly Dr Tulsa OK 74105-6317
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 1041S0200X

Profile Details

NPI number 1255721379
LBN Legal business name Willis, Lakesha
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 27th, 2015
Last updated Jan 27th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255721379 NPPES
Oklahoma MEDICAID 100746170G

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