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Individual

MS. GEORGENE W DWYER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC, LCPC

Contact information

Practice address
403 S CINCINNATI AVE, TULSA, OK 74103-5048
(918) 633-8590
(918) 742-2322
Mailing address
8930 S ERIE AVE, TULSA, OK 74137-3528
(918) 633-8590

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1238
OK
101YP2500X
Professional Counselor
CC2725
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
432227399
ME
Enumeration date
06/04/2006
Last updated
09/16/2009
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