Healthcare Provider Details

I. General information

NPI: 1134868565
Provider Name (Legal Business Name): CYNTHIA LYN MILFORD M.S., ED.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2022
Last Update Date: 06/02/2022
Certification Date: 06/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3840 S FLORENCE PL
TULSA OK
74105-3730
US

IV. Provider business mailing address

3840 S FLORENCE PL
TULSA OK
74105-3730
US

V. Phone/Fax

Practice location:
  • Phone: 918-625-7255
  • Fax:
Mailing address:
  • Phone: 918-625-7255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number192556
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: