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Contact Information

STATE OF OKLAHOMA
2323 SOUTH HARVARD
TULSA, OK74114
 Phone: 918-293-2140
 Fax: 918-712-7164
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Counselor

101Y00000X
 

Substance Abuse Disorder Rehabilitation Facility

324500000X
Indicates primary specialty

NPI Profile & details for STATE OF OKLAHOMA · (Female)

NPI # 1366689713
Status Active
Credentials
Entity Individual
Enumeration date 01/07/2009
Last updated 02/01/2011 - About 15 years ago
Sole proprietor 1 Not specified
Identifiers
  • OK License # 1750
  • OK License # 62
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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