Provider Demographics
NPI:1699056663
Name:CLEERE, SECILY RACHELLE
Entity type:Individual
Prefix:
First Name:SECILY
Middle Name:RACHELLE
Last Name:CLEERE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SECILY
Other - Middle Name:RACHELLE
Other - Last Name:TRIMBLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16215 ECONTUCHKA RD
Mailing Address - Street 2:
Mailing Address - City:EARLSBORO
Mailing Address - State:OK
Mailing Address - Zip Code:74840-3500
Mailing Address - Country:US
Mailing Address - Phone:405-584-1044
Mailing Address - Fax:
Practice Address - Street 1:112 MCKINLEY AVE
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:OK
Practice Address - Zip Code:74834-1622
Practice Address - Country:US
Practice Address - Phone:405-258-3040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-06
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst