Individual
MARY GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.W.
Contact information
Practice address
14002 E 21ST ST, SUITE 200, TULSA, OK 74134-1412
(918) 299-1017
Mailing address
11242 S KINGSTON AVE, TULSA, OK 74137-7727
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
0470
OK
Other
Enumeration date
12/17/2010
Last updated
12/17/2010
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