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Individual

MRS. STACIE ELIZABETH COSTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
7935 E 57TH ST, TULSA, OK 74145-8622
(918) 261-9601
(918) 371-0240
Mailing address
7935 E 57TH ST, TULSA, OK 74145-8622
(918) 212-8702

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5480
OK

Other

Enumeration date
11/30/2012
Last updated
11/18/2024
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