Provider Demographics
NPI:1043609993
Name:EDWARDS, TYFANY (LMSW)
Entity Type:Individual
Prefix:
First Name:TYFANY
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1607 N CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-4644
Mailing Address - Country:US
Mailing Address - Phone:918-425-4200
Mailing Address - Fax:
Practice Address - Street 1:1 W 36TH ST N
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74106-1700
Practice Address - Country:US
Practice Address - Phone:918-425-4200
Practice Address - Fax:918-663-0203
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-15
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker