Provider Demographics
NPI:1114277126
Name:ENGLAND, TAMMY (BS)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:ENGLAND
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 81
Mailing Address - Street 2:
Mailing Address - City:POTEAU
Mailing Address - State:OK
Mailing Address - Zip Code:74953-0081
Mailing Address - Country:US
Mailing Address - Phone:918-649-5135
Mailing Address - Fax:918-647-8121
Practice Address - Street 1:203 MICHELLE DR
Practice Address - Street 2:
Practice Address - City:POTEAU
Practice Address - State:OK
Practice Address - Zip Code:74953-2084
Practice Address - Country:US
Practice Address - Phone:918-649-5135
Practice Address - Fax:918-647-8121
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-17
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200226970Medicaid