Individual
TIFFANY P PHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BHRS
Contact information
Practice address
3515 S PENNSYLVANIA AVE, OKLAHOMA CITY, OK 73119-2100
(405) 426-9926
(405) 585-2465
Mailing address
5905 SAINT JAMES PL, OKLAHOMA CITY, OK 73179-7911
(405) 426-9926
(405) 585-2465
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/20/2012
Last updated
09/20/2012
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