Provider Demographics
NPI:1497195366
Name:HARLE, TUNYESE (CMII, WELLNESS COACH)
Entity type:Individual
Prefix:
First Name:TUNYESE
Middle Name:
Last Name:HARLE
Suffix:
Gender:F
Credentials:CMII, WELLNESS COACH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4324 NW 22ND ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73107-2624
Mailing Address - Country:US
Mailing Address - Phone:405-906-1961
Mailing Address - Fax:
Practice Address - Street 1:4400 N LINCOLN BLVD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73105-5104
Practice Address - Country:US
Practice Address - Phone:405-424-7711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-25
Last Update Date:2021-03-11
Deactivation Date:2014-01-13
Deactivation Code:
Reactivation Date:2014-04-08
Provider Licenses
StateLicense IDTaxonomies
171M00000X
OK103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty