Healthcare Provider Details

I. General information

NPI: 1437401981
Provider Name (Legal Business Name): VELVET BROWN-WATTS MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2012
Last Update Date: 10/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2625 N PEORIA AVE
TULSA OK
74106-2512
US

IV. Provider business mailing address

2625 N PEORIA AVE
TULSA OK
74106-2512
US

V. Phone/Fax

Practice location:
  • Phone: 918-794-0197
  • Fax: 918-794-0196
Mailing address:
  • Phone: 918-794-0197
  • Fax: 918-794-0196

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: