Carmen Portillo
Peer Specialist in Tulsa, OK. Individual provider (NPI-1).
NPI number1003659699
StatusActive
Last updated in NPPESJun 13, 2024
Details
- NPI
- 1003659699
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Carmen Portillo
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 13, 2024
- Certification date
- Jun 13, 2024
- Last updated
- Jun 13, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 175T00000X | Peer Specialist | – | OK | Yes |
Practice location
3847 S 98th East AveTulsa, OK 74146-2424
Phone 918-699-9373
Mailing address
3847 S 98th East AveTulsa, OK 74146-2424
Phone 918-699-9373
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