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PEDIATRIC NEUROPSYCHOLOGY ASSOCIATES PLLC

Clinical Neuropsychologist

Oklahoma City, Oklahoma

Provider NPI: 1760744718

Organization Information:
Organization Name:  PEDIATRIC NEUROPSYCHOLOGY ASSOCIATES PLLC
Organization is not Subpart
Authorized Official:  LORI  HOLMQUIST-DAY  PEDIATRIC NEUROPSYCHOLOGIST  405-7137065

Practice Location:
3330 NW 56TH ST SUITE 305 OKLAHOMA CITY, OK 73112 US
Tel: 405-713-7065  Fax: 405-713-7064

Business Mailing Address:
3330 NW 56TH ST SUITE 305 OKLAHOMA CITY, OK 73112 US
Tel: 405-713-7065  Fax: 405-713-7064

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
OK944

Other Provider Identifiers:

IssuerNumberStateType
200013880BOK05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







CLINICAL NEUROPSYCHOLOGIST JOBS OK - Page 1



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