Most Relevant Information
Provider Data
| NPI Number: | 1003547779 |
| Provider Name: | LAKENDRA JANELL GOULD |
| Entity Type: | Individual |
| Taxonomy Code: | 175T00000X |
| Specialty: | Peer Specialist |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/22/2022 |
| Last Updated: | 06/22/2022 |
Provider Practice Location
300 E ELM ST
EL RENO
OK
730364747
Practice Location Phone/Fax
| Phone: | 4054227476 |
| Fax: | 4054228218 |
Provider Mailing Location
300 E ELM ST
EL RENO
OK
730364747
Provider Mailing Phone/Fax
| Phone: | 4054227476 |
| Fax: | 4054228218 |