Tristan Daniel Hughes

Individual provider Active NPI Peer Specialist · Newalla, OK

NPI 1033734827 · NPPES record last updated Jun 8, 2020

Key facts

NPI
1033734827
Entity type
Individual (NPI type 1)
Primary specialty
Peer Specialist 175T00000X
Practice address
10700 S Choctaw Rd
Newalla, OK 74857-7962
Phone
(405) 301-3789
NPI assigned
Jun 8, 2020
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Peer Specialist 175T00000X Yes

Addresses

Primary practice location

10700 S Choctaw Rd
Newalla, OK 74857-7962

Mailing address

10700 S Choctaw Rd
Newalla, OK 74857-7962
Phone (918) 845-0147

Other providers in Newalla, OK

All providers in Newalla, OK · Peer Specialist in Oklahoma

Sources for this page

Verify at the official NPI Registry.