Individual
MS. LISA ANN STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED., LPC
Contact information
Practice address
1843 E 15TH ST, TULSA, OK 74104-4610
(918) 712-8800
(918) 712-8802
Mailing address
31 E 54TH ST, TULSA, OK 74105-6712
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4574
OK
Other
Enumeration date
05/17/2010
Last updated
06/13/2011
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