Organization
STREET SCHOOL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNY LYNN FITZGERALD LCSW (LEAD COUNSLEOR)
(918) 833-9815
Entity
Organization
Contact information
Practice address
1135 S YALE AVE, TULSA, OK 74112-5342
(918) 833-9815
(918) 833-9858
Mailing address
1135 S YALE AVE, TULSA, OK 74112-5342
(918) 833-9815
(918) 833-9858
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
3870
OK
Other
Enumeration date
11/05/2015
Last updated
11/05/2015
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