Individual
TOMMIE FORGOTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
624 NW 5TH ST, MOORE, OK 73160-3924
(405) 799-3379
Mailing address
624 NW 5TH ST, MOORE, OK 73160-3924
(405) 799-3379
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
8985
OK
Other
Enumeration date
10/12/2023
Last updated
10/12/2023
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