Individual
MISTI ANN CENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2504B E 21ST ST STE B, TULSA, OK 74114-1706
(918) 277-3746
Mailing address
2504 E 21ST ST STE B, TULSA, OK 74114-1759
(918) 277-3746
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3673
OK
Other
Enumeration date
01/27/2009
Last updated
02/11/2010
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