Individual
LISA GARDINER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1729 S BALTIMORE AVE, TULSA, OK 74119-4807
(918) 599-0532
Mailing address
3230 S WINSTON AVE APT 204, TULSA, OK 74135-2079
(918) 402-2258
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
11/15/2021
Last updated
11/15/2021
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