Individual
JORDAN GUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
4300 S HARVARD AVE, TULSA, OK 74135-2619
(918) 508-2776
Mailing address
4300 S HARVARD AVE, TULSA, OK 74135-2619
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/20/2015
Last updated
10/20/2015
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