MEDICARE: HEATHER DEVRIES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175T00000X	Peer Specialist

General Provider Information

NPI Number	:	1861343600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER DEVRIES

Provider Business Mailing Address
First Line	:	PO BOX 189
Second Line	:
City	:	ARDMORE
State	:	OK
Zip	:	73402-0189
Country	:	US
Telephone Number	:	580-319-7305
Fax Number	:	580-319-7328

Provider Business Practice Location Address
First Line	:	1219 K ST NW STE 2
Second Line	:
City	:	ARDMORE
State	:	OK
Zip	:	73401-1801
Country	:	US
Telephone Number	:	580-798-4523
Fax Number	:	580-319-5534

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2026
Last Update Date	:	02/06/2026

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1114878949 — CARMEN WRIGHT
Practice Location Address:

1219 K ST NW STE 2
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1184631756 — BAHA AL DEEN ABUESHEH MD PC
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1497825822 — TOMMIE J SMITH MS, LPC
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1669596763 — MR. JAMES B DRAIN C. PED.
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1235388000 — MICHELE R RUSS MBS, LPC
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1225378623 — LIGHTHOUSE BEHAVIORAL WELLNESS CENTERS
Practice Location Address:

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Directions to “ HEATHER DEVRIES ” Practice Location

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