Most Relevant Information
Provider Data
| NPI Number: | 1003520388 |
| Provider Name: | TOLISSA AUTRY MHR |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/10/2023 |
| Last Updated: | 01/10/2023 |
Provider Practice Location
2325 S HARVARD AVE
TULSA
OK
741143300
Practice Location Phone/Fax
| Phone: | 9188590986 |
| Fax: |
Provider Mailing Location
5516 E 35TH ST
TULSA
OK
741355224
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |