Individual
MR. MICHAEL A. BLACET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW-P
Contact information
Practice address
4930 S SHERIDAN RD, TULSA, OK 74145-5712
(918) 392-4008
(918) 392-4009
Mailing address
2005 W TOLEDO PL, BROKEN ARROW, OK 74012-5136
(918) 815-5425
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4693-P
OK
Other
Enumeration date
03/01/2013
Last updated
10/09/2013
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