Individual
TIFFANI MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11513 GREYSTONE AVE, OKLAHOMA CITY, OK 73120-6620
(405) 753-4196
Mailing address
PO BOX 721751, OKLAHOMA CITY, OK 73172-1825
(405) 753-4196
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/31/2011
Last updated
10/31/2011
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