Individual
LISA DAHLSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
311 S MADISON AVE, TULSA, OK 74120-3208
(918) 582-0061
Mailing address
311 S MADISON AVE, TULSA, OK 74120-3208
(918) 582-0061
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
02/19/2010
Last updated
02/19/2010
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