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Individual

MISS TEOLA ANN MAYTUBBY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW

Contact information

Practice address
128 N 12TH AVE, DURANT, OK 74701-4718
(580) 745-9276
(580) 920-9056
Mailing address
107 S HIGH ST, ANTLERS, OK 74523-3818
(580) 298-2830
(580) 298-6723

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
1041C0700X
Clinical Social Worker
Primary
9178-P
OK

Other

Enumeration date
05/04/2007
Last updated
08/12/2024
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