Individual
SHERELLE MIGNON PETERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4004 W 55TH PL, TULSA, OK 74107-9526
(918) 706-8058
Mailing address
4004 W 55TH PL, TULSA, OK 74107-9526
(918) 706-8058
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
104100000X
Social Worker
—
—
Other
Enumeration date
10/13/2012
Last updated
10/13/2012
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