Doctor Name: | TRACY TERNES |
NPI Number: | 1225273105 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 231 E Graham Pryor, OK - 74361 |
Business Phone Number: | 9188251405 |
Business Fax Number: | |
Mailing Address: | 42663 E 181st Street S, PORTER |
State: | OK |
Postal Code: | 74454 |
Phone Number: | 9185046542 |
Fax Number: | |
NPI Enumeration Date: | 12/08/2008 |
NPI Last Update Date: | 12/08/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |