Provider Demographics
NPI:1154618734
Name:TAGUE, SCARLETT BAKER (BA)
Entity type:Individual
Prefix:
First Name:SCARLETT
Middle Name:BAKER
Last Name:TAGUE
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 S BERRY RD STE 200
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-7480
Mailing Address - Country:US
Mailing Address - Phone:405-615-2919
Mailing Address - Fax:
Practice Address - Street 1:20814 250TH ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:OK
Practice Address - Zip Code:73093-4604
Practice Address - Country:US
Practice Address - Phone:405-615-2919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-05
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health