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Individual

ANGELA MCKENZIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
1515 S CARSON AVE, TULSA, OK 74119-3845
(918) 818-7438
Mailing address
13848 226TH ST, LAURELTON, NY 11413-2743

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
096113
NY
104100000X
Social Worker
20690
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
096113
NY
05
20690
OK
Enumeration date
11/16/2022
Last updated
02/19/2024
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