Provider Demographics
NPI:1831468230
Name:MCLAUGHLIN, TRACEY LEE (BCND, CNC, CHS, MH,)
Entity Type:Individual
Prefix:DR
First Name:TRACEY
Middle Name:LEE
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:BCND, CNC, CHS, MH,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6440 AVONDALE DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NICHOLS HILLS
Mailing Address - State:OK
Mailing Address - Zip Code:73116-6421
Mailing Address - Country:US
Mailing Address - Phone:405-409-5742
Mailing Address - Fax:405-254-5574
Practice Address - Street 1:6440 AVONDALE DR
Practice Address - Street 2:SUITE 200
Practice Address - City:NICHOLS HILLS
Practice Address - State:OK
Practice Address - Zip Code:73116-6421
Practice Address - Country:US
Practice Address - Phone:405-409-5742
Practice Address - Fax:405-254-5574
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-14
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133NN1002X, 173C00000X, 174400000X, 174H00000X
NV81246175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No173C00000XOther Service ProvidersReflexologist
No174400000XOther Service ProvidersSpecialist
No174H00000XOther Service ProvidersHealth Educator