Individual
MRS. TIFFANY CLEVETTE BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3447 COBBLESTONE CT, SPENCER, OK 73084-3258
(405) 243-5514
Mailing address
3447 COBBLESTONE CT, SPENCER, OK 73084-3258
(405) 243-5514
Taxonomy
Speciality
Code
Description
License number
State
103TR0400X
Rehabilitation Psychologist
Primary
—
—
Other
Enumeration date
05/03/2011
Last updated
05/03/2011
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