MISS Travice L Lewallen

NPI #1578319729 in Heavener, Oklahoma

Provider Information

NPI Number: 1578319729
Entity Type: Individual
Name: MISS Travice L Lewallen
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Case Manager/Care Coordinator
Enumeration Date: Apr 29, 2024
Last Updated: Apr 29, 2024

Practice Location

Address: 511 E 2ND ST
City: Heavener
State: Oklahoma
ZIP Code: 74937-3419
Phone: (918) 653-7718

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Case Manager/Care Coordinator	171M00000X	Primary

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