Individual provider · Type 1 NPI

Tracy Leigh Wilde, BA

Peer Specialist · Broken Arrow, OK

NPI number 1104143213 Active

Practice location

7015 S Dogwood Pl
Broken Arrow, OK 74011-2071

Call (918) 630-3566 Map

Specialties and licenses

TaxonomyCodeLicense
Case Manager/Care Coordinator 171M00000XNone listed
Peer Specialist Primary 175T00000XNone listed

Peer Specialist: Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

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About NPI 1104143213

Tracy Leigh Wilde, BA's National Provider Identifier is 1104143213, issued on Apr 28, 2010. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Broken Arrow, OK. The record was last updated on Apr 17, 2026.