Individual
ELIZABETH AMELIA FORNONI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11740 E 21ST ST, TULSA, OK 74129-1820
(918) 437-9495
Mailing address
8748 N MINGO RD APT 1120, OWASSO, OK 74055-5076
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6270
OK
Other
Enumeration date
07/18/2018
Last updated
07/18/2018
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