Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist |
NPI | 1073891594 |
---|---|
Provider Name | Caley Deann Gregg |
First Address | Norman, OK 73069 |
Second Address | Norman, OK 73069-5106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2011 |
Last Update Date | 13/08/2015 |