Individual
VALISA DONNA WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2808 E 71ST ST #C, TULSA, OK 74136-5572
(918) 794-6570
(918) 340-5189
Mailing address
1225 N DENVER AVE, TULSA, OK 74106
(918) 829-0881
(918) 340-5189
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200292350B
—
OK
Enumeration date
06/22/2023
Last updated
06/22/2023
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