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Tracy Leann Rider
Peer Specialist in Commerce, Oklahoma
NPI 1467171702

Tracy Leann Rider is a Peer Specialist based in Commerce, OK. Tracy Leann Rider practices in Commerce, OK. The NPI Number for Tracy Leann Rider is 1467171702 and holds a License No. (Oklahoma).

The current practice location address for Tracy Leann Rider is 304 N Mickey Mantle Blvd, Commerce, OK and can be reached out via phone at 918-675-4100.

Location: 304 N Mickey Mantle Blvd, Commerce, OK, 74339-1110
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1467171702
Provider Name
Tracy Leann Rider
Credential
Provider Entity Type
Individual
Gender
Female
Address
304 N Mickey Mantle Blvd, Commerce, OK, 74339-1110
Phone Number
918-675-4100
Fax Number
Provider Enumeration Date
08/22/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
304 N Mickey Mantle Blvd
City
Commerce
State
Oklahoma
Zip
74339-1110
Phone Number
918-675-4100
Fax Number
person
Provider Business Mailing Address Details
Address
304 N Mickey Mantle Blvd
City
Commerce
State
Oklahoma
Zip
74339-1110
Phone Number
918-675-4100
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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