Healthcare Provider Details

I. General information

NPI: 1528705886
Provider Name (Legal Business Name): MRS. HAYLEY YORK WOOD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2022
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6216 S LEWIS AVE STE 102
TULSA OK
74136-1075
US

IV. Provider business mailing address

7338 E 92ND ST
TULSA OK
74133-6039
US

V. Phone/Fax

Practice location:
  • Phone: 918-416-4483
  • Fax:
Mailing address:
  • Phone: 405-642-6085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number12111
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: