Provider Demographics
NPI:1689787681
Name:FERRERA, TAIS HELENA (MS)
Entity Type:Individual
Prefix:MS
First Name:TAIS
Middle Name:HELENA
Last Name:FERRERA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1722 DENIM LN
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73703-1614
Mailing Address - Country:US
Mailing Address - Phone:580-242-5544
Mailing Address - Fax:580-233-8905
Practice Address - Street 1:230 W MAPLE AVE
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-4012
Practice Address - Country:US
Practice Address - Phone:580-242-5544
Practice Address - Fax:580-233-8905
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health