Provider Demographics
NPI:1255008918
Name:OBRIEN, TARYN SHIRLEY
Entity Type:Individual
Prefix:
First Name:TARYN
Middle Name:SHIRLEY
Last Name:OBRIEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 S ELWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74119-4208
Mailing Address - Country:US
Mailing Address - Phone:918-587-3888
Mailing Address - Fax:918-587-3891
Practice Address - Street 1:1608 S ELWOOD AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74119-4208
Practice Address - Country:US
Practice Address - Phone:918-587-3888
Practice Address - Fax:918-587-3891
Is Sole Proprietor?:No
Enumeration Date:2021-08-30
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker