Individual
MRS. LISA WIEDENHAUPT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3227 E 31ST ST, SUITE 200, TULSA, OK 74105-2453
(918) 749-4600
(918) 749-7144
Mailing address
3227 E 31ST ST, SUITE 200, TULSA, OK 74105-2453
(918) 749-4600
(918) 749-7144
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1041000000X
OK
Other
Enumeration date
01/20/2016
Last updated
01/24/2023
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