Individual
MRS. THOMASINE L. FIFE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
100 W 7TH ST STE 102, OKMULGEE, OK 74447-5007
(918) 758-1930
Mailing address
100 W 7TH ST STE 102, OKMULGEE, OK 74447-5007
(918) 758-1930
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300522336
MEDICARE
OK
Enumeration date
06/05/2009
Last updated
06/09/2009
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