Individual
MISS TIFHANIE EDISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
118 IMPERIAL BLVD, SANDSPRINGS, OK 74063
(918) 245-9488
Mailing address
118 IMPERIAL BLVD, SAND SPRINGS, OK 74063-7113
(918) 245-9488
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
08/21/2014
Last updated
08/21/2014
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