Individual
BOBBY GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2548 E KENOSHA ST, BROKEN ARROW, OK 74014-6712
(918) 355-0993
Mailing address
14710 E 39TH ST S, TULSA, OK 74134-5632
(918) 378-2644
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
04/01/2024
Last updated
04/01/2024
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