Provider Demographics
NPI:1922828276
Name:FERRARI, TAMMY LOUISE
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:LOUISE
Last Name:FERRARI
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 1:1848 SURREY DR
Mailing Address - Street 2:
Mailing Address - City:PRYOR
Mailing Address - State:OK
Mailing Address - Zip Code:74361-8429
Mailing Address - Country:US
Mailing Address - Phone:479-561-4858
Mailing Address - Fax:
Practice Address - Street 1:320 S BOSTON AVE STE 825A
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74103-3728
Practice Address - Country:US
Practice Address - Phone:918-609-0404
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-11
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKLPCCANDIDATE12434101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health