Doctor Name: | TAMRA LEE BOK |
NPI Number: | 1154653467 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A. |
License Number: | 10324 |
Business Practice Address: | 300 West Lake Ave, Suite 4 Woodland Park, CO - 80866 |
Business Phone Number: | 7196872880 |
Business Fax Number: | 7195726299 |
Mailing Address: | 220 Ruskin Drive, COLORADO SPRINGS |
State: | CO |
Postal Code: | 80910 |
Phone Number: | 7195726100 |
Fax Number: | 7195726199 |
NPI Enumeration Date: | 02/11/2010 |
NPI Last Update Date: | 04/01/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 10324 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CO |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |