IndividualActive
Amanda Etheridge
NPI 1104123405 · Community/Behavioral Health Agency · Tulsa, OK
Provider details
- NPI number
- 1104123405
- Entity type
- Individual
- Primary specialty
- Community/Behavioral Health AgencyAgencies
- Sex
- Female
- Sole proprietor
- Yes
Specialties & taxonomies
Agencies
Practice location
6202 S Lewis Ave Ste J
Tulsa, OK 74136-1064
Phone: (918) 392-7988
Approximate (ZIP-level) locationGet directions
Mailing address
6202 S Lewis Ave Ste J
Tulsa, OK 74136-1064
Registry dates
- Enumerated
- 2011-02-22
- Last updated
- 2021-08-27
- Certified
- 2021-08-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.