Provider Demographics
NPI:1922409713
Name:MCCLARY, ADRIENNE RENE
Entity Type:Individual
Prefix:MS
First Name:ADRIENNE
Middle Name:RENE
Last Name:MCCLARY
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 1:7500 E 151ST ST S
Mailing Address - Street 2:LOT 33
Mailing Address - City:BIXBY
Mailing Address - State:OK
Mailing Address - Zip Code:74008-4144
Mailing Address - Country:US
Mailing Address - Phone:918-924-0589
Mailing Address - Fax:
Practice Address - Street 1:7500 E 151ST ST S
Practice Address - Street 2:LOT 33
Practice Address - City:BIXBY
Practice Address - State:OK
Practice Address - Zip Code:74008-4144
Practice Address - Country:US
Practice Address - Phone:918-924-0589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-11
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor