Individual
EZY SIQUEIROS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3124 E APACHE ST, TULSA, OK 74110-2320
(918) 508-2717
(918) 508-2788
Mailing address
6941 S JOPLIN AVE APT 1210, TULSA, OK 74136-3541
(918) 851-6937
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
09/14/2022
Last updated
09/14/2022
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