Individual
TIFFANY C CHANCELLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1209 KINGSTON DR, YUKON, OK 73099-5413
(405) 593-3280
Mailing address
1209 KINGSTON DR, YUKON, OK 73099-5413
(405) 593-3280
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
20628-P
OK
Other
Enumeration date
04/23/2024
Last updated
04/23/2024
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