Individual
AUDREY KATHERINE BRYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1620 E 12TH ST, TULSA, OK 74120-5407
(918) 582-2131
Mailing address
1620 E 12TH ST, TULSA, OK 74120-5407
(918) 582-2131
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1696
OK
Other
Enumeration date
11/12/2007
Last updated
11/12/2007
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