Individual
TINA M BEVANS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3010 S HARVARD AVE, STE 110, TULSA, OK 74114-6126
(918) 313-2142
Mailing address
PO BOX 140353, BROKEN ARROW, OK 74014-0017
(918) 313-2142
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3592
OK
Other
Enumeration date
06/01/2007
Last updated
09/21/2016
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