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Individual

IRVIN DWAYNE PROFIT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LADC U/S

Contact information

Practice address
5319 S. LEWIS, STE 219, TULSA, OK 74105
(918) 832-7763
(918) 292-8250
Mailing address
5319 S. LEWIS, STE 219, TULSA, OK 74105
(918) 832-7763
(918) 292-8250

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Enumeration date
07/12/2007
Last updated
09/26/2013
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