Individual
ERICA TATUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1621 NE 25TH ST, OKLAHOMA CITY, OK 73111-3220
(405) 999-7757
Mailing address
1621 NE 25TH ST, OKLAHOMA CITY, OK 73111-3220
(405) 999-7757
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
03/23/2013
Last updated
03/23/2013
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