Individual
MYKEISHA AUDRIANNA GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5308 N NORFOLK AVE, TULSA, OK 74126-2719
(918) 638-2218
Mailing address
5308 N NORFOLK AVE, TULSA, OK 74126-2719
(918) 638-2218
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
12/25/2019
Last updated
12/25/2019
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