Most Relevant Information
Provider Data
| NPI Number: | 1003307901 |
| Provider Name: | MILAGRO TAURUS MSW LCSW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 5856 |
Most Important Dates
| Enumeration Date: | 05/25/2018 |
| Last Updated: | 05/25/2018 |
Provider Practice Location
6051 N BROOKLINE AVE
SUITE 127
OKLAHOMA
OK
73112
Practice Location Phone/Fax
| Phone: | 4059790127 |
| Fax: |
Provider Mailing Location
1316 NE 12TH STREET
#709
OKLAHOMA
OK
73117
Provider Mailing Phone/Fax
| Phone: | 4059790127 |
| Fax: |