Individual
MISTY UPSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW PROVISIONAL
Contact information
Practice address
1608 S ELWOOD AVE, TULSA, OK 74119-4208
(918) 587-3888
Mailing address
1608 S ELWOOD AVE, TULSA, OK 74119-4208
(918) 587-3888
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
21067-P
OK
Other
Enumeration date
07/18/2024
Last updated
08/29/2024
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