Individual
DANA MACON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2108 N CINCINNATI AVE, TULSA, OK 74106-3717
(918) 798-4282
Mailing address
2108 N. CINCINNATI AVE, TULSA, OK 74106
(918) 798-4282
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
004129260
OK
103K00000X
Behavior Analyst
—
OK
Other
Enumeration date
10/10/2013
Last updated
03/19/2014
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