Individual
CHRISTY TANUSAPUTRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, NCC, LPC, LAC
Contact information
Practice address
5200 S YALE AVE STE 400, TULSA, OK 74135-7489
(918) 236-0150
Mailing address
4038 E 53RD ST, TULSA, OK 74135-4816
(918) 688-0903
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
12274
CO
101YA0400X
Addiction (Substance Use Disorder) Counselor
325
CO
101YP2500X
Professional Counselor
0011344
CO
101YP2500X
Professional Counselor
Primary
10674
OK
Other
Enumeration date
01/01/2012
Last updated
11/26/2023
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