Provider Demographics
NPI:1558650895
Name:HALE, TAMMIE LOUISE
Entity Type:Individual
Prefix:
First Name:TAMMIE
Middle Name:LOUISE
Last Name:HALE
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 1:3120 NW DREXEL CT
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73107-5228
Mailing Address - Country:US
Mailing Address - Phone:405-778-8260
Mailing Address - Fax:
Practice Address - Street 1:3033 NW 63RD ST STE E-200
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-3634
Practice Address - Country:US
Practice Address - Phone:405-254-5228
Practice Address - Fax:888-688-7013
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-06
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst