Individual
TAMRA RENE THETREAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
90 N 31ST ST, CLINTON, OK 73601-9116
(580) 323-6021
(580) 331-2007
Mailing address
90 N 31ST, CLINTON, OK 73601
(580) 323-6021
(580) 331-2007
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
05/24/2011
Last updated
05/24/2011
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