Provider Demographics
NPI:1487191748
Name:CROOMS, D'ANDRIA
Entity Type:Individual
Prefix:
First Name:D'ANDRIA
Middle Name:
Last Name:CROOMS
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 1:426 S 77TH EAST AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74112-2126
Mailing Address - Country:US
Mailing Address - Phone:918-720-9863
Mailing Address - Fax:918-794-9622
Practice Address - Street 1:130 N GREENWOOD AVE
Practice Address - Street 2:305
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74120-1443
Practice Address - Country:US
Practice Address - Phone:918-794-9696
Practice Address - Fax:918-794-9622
Is Sole Proprietor?:No
Enumeration Date:2017-01-25
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health