Provider Demographics
NPI:1346514957
Name:SCOTT, TYREE VERNELL (BHRS)
Entity Type:Individual
Prefix:
First Name:TYREE
Middle Name:VERNELL
Last Name:SCOTT
Suffix:
Gender:M
Credentials:BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9613 WARRINGER CT
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-6409
Mailing Address - Country:US
Mailing Address - Phone:405-537-8458
Mailing Address - Fax:
Practice Address - Street 1:8801 S OLIE AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-9359
Practice Address - Country:US
Practice Address - Phone:405-616-2442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-28
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor