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General NPI Number Information
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NPI Number | 1720313604
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Entity Type | Individual
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Provider Name | TAMMY WARREN LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/09/2009
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Last Update Date | 07/28/2015
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Provider Practice Location Address
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Address Line | 928 N YORK ST SUITE 14
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City | MUSKOGEE
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State | OK
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Zip | 74403-3123
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Country | US
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Telephone | 918-577-5039
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Fax |
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Provider Business Mailing Address
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Address Line | 1944 E MOFFETT LN
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City | FORT GIBSON
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State | OK
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Zip | 74434-7607
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Country | US
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Telephone | 918-577-5039
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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