Individual
TARA SERVELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4001 N CLASSEN BLVD STE 225, OKLAHOMA CITY, OK 73118-2670
(405) 231-3150
Mailing address
4001 N CLASSEN BLVD STE 225, OKLAHOMA CITY, OK 73118-2670
(405) 231-3150
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
12162
OK
Other
Enumeration date
05/10/2024
Last updated
05/10/2024
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