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NPI Code Detail

MEDICARE: MISS TIFFANY MARIE GRECO LCSW

MEDICARE: MISS TIFFANY MARIE GRECO LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker3889OK

General Provider Information

NPI Number : 1790918720
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS TIFFANY MARIE GRECO LCSW
Provider Business Mailing Address
First Line : 1516 S BOSTON AVE
Second Line :
City : TULSA
State : OK
Zip : 74119-4003
Country : US
Telephone Number : 918-561-6000
Fax Number : 918-561-6001
Provider Business Practice Location Address
First Line : 1516 S BOSTON AVE
Second Line :
City : TULSA
State : OK
Zip : 74119-4003
Country : US
Telephone Number : 918-561-6000
Fax Number : 918-561-6001
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2009
Last Update Date : 01/14/2010

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Directions to “ MISS TIFFANY MARIE GRECO LCSW” Practice Location

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