| Doctor Name: | TRACY J LORAH |
| NPI Number: | 1467714766 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A./US |
| License Number: | /US |
| Business Practice Address: | 2 Wickersham St Mangum, OK - 735549117 |
| Business Phone Number: | 5807823337 |
| Business Fax Number: | 5807823338 |
| Mailing Address: | 3020 Garrison Rd, ALTUS |
| State: | OK |
| Postal Code: | 735211279 |
| Phone Number: | 5804715142 |
| Fax Number: | 5804826388 |
| NPI Enumeration Date: | 06/12/2012 |
| NPI Last Update Date: | 04/29/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | /US |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OK |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |