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Individual

TIFFANY DAWN STOKELY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1701 E PARK PL, OKLAHOMA, OK 73117
(405) 468-3139
Mailing address
1701 E PARK PL, OKLAHOMA, OK 73117
(405) 468-3139

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
392068921
PRIVATE ORGANIZATION
OK
Enumeration date
08/29/2012
Last updated
08/29/2012
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