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Individual

AMANDA PEEVSASSER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
3015 E SKELLY DR, STE. 103, TULSA, OK 74105-6317
(918) 712-0859
(918) 388-6456
Mailing address
1611 S DENVER AVE, TULSA, OK 74119-4232
(918) 900-1511

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
1041C0700X
Clinical Social Worker
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100746170G
OK
Enumeration date
10/23/2013
Last updated
02/26/2025
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