Individual
MR. DAEVA BLACC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3322 E 30TH ST, TULSA, OK 74114-6108
(918) 724-5680
(918) 743-8845
Mailing address
3322 E 30TH ST, TULSA, OK 74114-6108
(918) 724-5680
(918) 743-8845
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
05/03/2012
Last updated
05/03/2012
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