Provider Demographics
NPI:1407052855
Name:BRATCHER, AMANDA CAROL (BSW, CM-A)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:CAROL
Last Name:BRATCHER
Suffix:
Gender:F
Credentials:BSW, CM-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 COUNTY ROAD 1500
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:OK
Mailing Address - Zip Code:74872
Mailing Address - Country:US
Mailing Address - Phone:580-223-4550
Mailing Address - Fax:580-226-6153
Practice Address - Street 1:2530 SOUTH COMMERCE, BLDG. A
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-5519
Practice Address - Country:US
Practice Address - Phone:580-223-4550
Practice Address - Fax:580-226-6153
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)