Individual
PROF. FAITH ILESHA JEFFERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
228 S 101ST EAST AVE, TULSA, OK 74128-1232
(918) 779-8983
Mailing address
228 S 101ST EAST AVE, TULSA, OK 74128-1232
(918) 779-8983
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
05/07/2021
Last updated
05/07/2021
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