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Individual

MARY PRISCA ETHEL ELEANYA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
2339 S GARY PL, TULSA, OK 74114-1806
(908) 759-6054
Mailing address
2339 S GARY PL, TULSA, OK 74114-1806
(908) 759-6054

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
109137-01
NY
101YM0800X
Mental Health Counselor
102227
NY
101YM0800X
Mental Health Counselor
22288
OK

Other

Enumeration date
09/03/2020
Last updated
04/29/2026
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