Provider Demographics
NPI:1447598263
Name:STARKS, TAMMY LAFAYE
Entity Type:Individual
Prefix:MISS
First Name:TAMMY
Middle Name:LAFAYE
Last Name:STARKS
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 1:1334 WEST MARSHALL ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74127
Mailing Address - Country:US
Mailing Address - Phone:918-809-5558
Mailing Address - Fax:
Practice Address - Street 1:1334 W MARSHALL ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74127-5321
Practice Address - Country:US
Practice Address - Phone:918-809-5558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-29
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst