Individual
KARISSA HODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1111 W 17TH ST, TULSA, OK 74107-1886
(918) 582-1972
Mailing address
1111 W 17TH ST, TULSA, OK 74107-1886
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/13/2024
Last updated
09/13/2024
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