Lanica Willaby

NPI #1578101002 in Wagoner, Oklahoma

Provider Information

NPI Number: 1578101002
Entity Type: Individual
Name: Lanica Willaby
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Peer Specialist
Enumeration Date: Dec 16, 2019
Last Updated: Dec 16, 2019

Practice Location

Address: 307 E CHEROKEE ST
City: Wagoner
State: Oklahoma
ZIP Code: 74467-4729
Phone: (918) 485-7991

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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