Provider Demographics
NPI:1356529259
Name:ADAMS, TRACY JO (MSW)
Entity type:Individual
Prefix:
First Name:TRACY
Middle Name:JO
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:628 ALLISON LN
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-0007
Mailing Address - Country:US
Mailing Address - Phone:405-735-9026
Mailing Address - Fax:
Practice Address - Street 1:3100 SW 89TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-7900
Practice Address - Country:US
Practice Address - Phone:405-602-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-04
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker