Individual
TERRIA N FLETCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
2904 S JUNIPER AVE, BROKEN ARROW, OK 74012-7702
(918) 954-3329
Mailing address
PO BOX 703190, TULSA, OK 74170-3190
(918) 954-3329
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
OK
104100000X
Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1265817332
1265817332
OK
05
—
1265817332
—
OK
Enumeration date
07/29/2015
Last updated
07/15/2021
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