Individual
LANDIN GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5310 E 31ST ST, TULSA, OK 74135-5012
(918) 600-3100
Mailing address
901 S LIONS AVE, BROKEN ARROW, OK 74012-8424
(918) 729-9269
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
22532
OK
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
06/03/2022
Last updated
07/27/2026
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