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Individual

TAHLINA WEIR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
205 COTTONWOOD, POCOLA, OK 74902-2340
(918) 571-0414
Mailing address
205 COTTONWOOD, POCOLA, OK 74902-2340
(918) 571-0414

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
04211989
SELF
OK
Enumeration date
10/10/2019
Last updated
10/10/2019
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