Individual
TRACIE STONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
205 S ADAIR ST, PRYOR, OK 74361-5201
(918) 825-4872
(918) 825-4873
Mailing address
108 N ROWE ST, PRYOR, OK 74361-3833
(918) 961-2247
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200240050A
—
OK
Enumeration date
01/08/2014
Last updated
10/18/2021
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