Individual
JEWEL STREET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6130 E 32ND ST STE 121, TULSA, OK 74135-5454
(918) 932-8774
Mailing address
6130 E 32ND ST, TULSA, OK 74135-5476
(918) 932-8774
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/25/2020
Last updated
01/25/2020
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