Healthcare Provider Details

I. General information

NPI: 1346132016
Provider Name (Legal Business Name): TEENA GREENFEATHER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2025
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

618 E CANADIAN AVE
VINITA OK
74301-3810
US

IV. Provider business mailing address

PO BOX 148
VINITA OK
74301-0148
US

V. Phone/Fax

Practice location:
  • Phone: 918-256-3424
  • Fax:
Mailing address:
  • Phone: 918-219-3528
  • Fax: 918-713-8021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: