Individual
MRS. TARA PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7477 E 46TH PL, TULSA, OK 74145-6305
(918) 384-0002
Mailing address
11305 E 4TH ST, TULSA, OK 74128-2006
(918) 260-9428
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
06/29/2022
Last updated
06/29/2022
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