Provider Demographics
NPI:1801162425
Name:ALLEN, TAMARA LOU (MASTERS COUNSELING)
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:LOU
Last Name:ALLEN
Suffix:
Gender:F
Credentials:MASTERS COUNSELING
Other - Prefix:
Other - First Name:TAMARA
Other - Middle Name:LOU
Other - Last Name:COOKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12005 SW 51ST ST
Mailing Address - Street 2:
Mailing Address - City:MUSTANG
Mailing Address - State:OK
Mailing Address - Zip Code:73064-7909
Mailing Address - Country:US
Mailing Address - Phone:918-978-7892
Mailing Address - Fax:
Practice Address - Street 1:16301 SONOMA PARK DR
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-2091
Practice Address - Country:US
Practice Address - Phone:405-246-5433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-28
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK11741101YP2500X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional