Provider Demographics
NPI:1972049765
Name:GASKIN, TAMARA (MS)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:
Last Name:GASKIN
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 1:908 S LEE ST STE A
Mailing Address - Street 2:
Mailing Address - City:FORT GIBSON
Mailing Address - State:OK
Mailing Address - Zip Code:74434-8735
Mailing Address - Country:US
Mailing Address - Phone:918-203-3789
Mailing Address - Fax:918-203-3116
Practice Address - Street 1:908 S LEE ST STE A
Practice Address - Street 2:
Practice Address - City:FORT GIBSON
Practice Address - State:OK
Practice Address - Zip Code:74434-8735
Practice Address - Country:US
Practice Address - Phone:918-203-3789
Practice Address - Fax:918-203-3116
Is Sole Proprietor?:No
Enumeration Date:2017-01-17
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist