Healthcare Provider Details

I. General information

NPI: 1386998326
Provider Name (Legal Business Name): TRACEY JONES BHRS/CM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/29/2012
Last Update Date: 02/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 W WILSHIRE BLVD SUITE 114
OKLAHOMA CITY OK
73116-7781
US

IV. Provider business mailing address

730 W WILSHIRE BLVD SUITE 114
OKLAHOMA CITY OK
73116-7781
US

V. Phone/Fax

Practice location:
  • Phone: 405-843-4673
  • Fax:
Mailing address:
  • Phone: 405-843-4673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: