Individual
TIFFANY SCOTT MCCOLLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PRSS
Contact information
Practice address
8515 NE 25TH ST, SPENCER, OK 73084-3818
(405) 796-7010
Mailing address
1126 NW 10TH ST, OKLAHOMA CITY, OK 73106-7032
(405) 679-6525
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OK
Other
Enumeration date
01/15/2020
Last updated
01/15/2020
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