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Individual

TIFFANY MATHES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
1215 NW 25TH ST, OKLAHOMA CITY, OK 73106-5629
(405) 525-2525
(405) 524-3549
Mailing address
1215 NW 25TH ST, OKLAHOMA CITY, OK 73106-5629

Taxonomy

Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
59721
OK

Other

Enumeration date
06/12/2014
Last updated
06/12/2014
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