Individual
MAYRA GABRIELA CANALES SEBASTIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2321 E 3RD ST, TULSA, OK 74104-1831
(918) 622-0641
Mailing address
1741 S FLORENCE AVE, TULSA, OK 74104-6105
(573) 356-2404
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7542
OK
Other
Enumeration date
11/22/2021
Last updated
11/22/2021
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