Provider Demographics
NPI:1437636347
Name:LEWIS-HAGGARD, TAMAIRA SUE
Entity Type:Individual
Prefix:
First Name:TAMAIRA
Middle Name:SUE
Last Name:LEWIS-HAGGARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TAMMY
Other - Middle Name:
Other - Last Name:HAGGARD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:805 E ROBINSON ST
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-6610
Mailing Address - Country:US
Mailing Address - Phone:405-447-4499
Mailing Address - Fax:
Practice Address - Street 1:805 E ROBINSON ST
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-6610
Practice Address - Country:US
Practice Address - Phone:405-447-4499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-24
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional