Individual
AMY LEANNE CALLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
102 N DENVER AVE, TULSA, OK 74103-1806
(918) 852-1200
Mailing address
102 N DENVER AVE, TULSA, OK 74103-1806
(918) 582-1200
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
134688
OK
175T00000X
Peer Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457537037
—
OK
Enumeration date
11/15/2023
Last updated
05/31/2024
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