Individual
CHELSEA THREADGILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3015 E. SKELLY DR., SUITE 103, TULSA, OK 74105-6344
(918) 712-0859
(918) 388-6456
Mailing address
3015 E. SKELLY DRL, SUITE 103, TULSA, OK 74105-6344
(918) 712-0859
(918) 388-6456
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200323940
—
OK
Enumeration date
01/24/2017
Last updated
01/24/2017
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