Most Relevant Information
Provider Data
| NPI Number: | 1003433772 |
| Provider Name: | IRENE DE LA TORRE |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/29/2020 |
| Last Updated: | 06/29/2020 |
Provider Practice Location
4720 S SHIELDS BLVD
OKLAHOMA CITY
OK
731293210
Practice Location Phone/Fax
| Phone: | 4056344400 |
| Fax: |
Provider Mailing Location
4720 S SHIELDS BLVD
OKLAHOMA CITY
OK
731293210
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |