Provider Demographics
NPI:1588901102
Name:CARR, TRISHA
Entity type:Individual
Prefix:
First Name:TRISHA
Middle Name:
Last Name:CARR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1525 W COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:GUTHRIE
Mailing Address - State:OK
Mailing Address - Zip Code:73044-2301
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:201 W OKLAHOMA AVE
Practice Address - Street 2:SUITE 218-219
Practice Address - City:GUTHRIE
Practice Address - State:OK
Practice Address - Zip Code:73044-3144
Practice Address - Country:US
Practice Address - Phone:405-282-2934
Practice Address - Fax:405-282-2909
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-16
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health