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General NPI Number Information
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NPI Number | 1275913691
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Entity Type | Individual
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Provider Name | TYLER STONE LMSW
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Gender | Male
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Dates
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Enumeration Date | 06/01/2015
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Last Update Date | 06/17/2024
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Provider Practice Location Address
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Address Line | 2360 HIGHWAY 62
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City | OKMULGEE
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State | OK
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Zip | 74447-6728
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Country | US
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Telephone | 918-758-1910
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Fax |
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Provider Business Mailing Address
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Address Line | 300 N MISSION LN
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City | OKMULGEE
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State | OK
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Zip | 74447-3909
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Country | US
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Telephone | 918-758-1930
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 20160
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License Number State | OK
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