Individual
CLESHAWN DUBOSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4815 S HARVARD AVE STE 275, TULSA, OK 74135-3052
(918) 973-3841
Mailing address
4815 S HARVARD AVE STE 275, TULSA, OK 74135-3052
(918) 973-3841
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
6315
OK
101YM0800X
Mental Health Counselor
6315
OK
101YP2500X
Professional Counselor
Primary
6315
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200287120A
—
OK
Enumeration date
08/23/2012
Last updated
05/12/2025
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