Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | ||
N | 103TH0100X | Health Service |
NPI | 1063056737 |
---|---|
Provider Name | Dr. Daniel Lawrence Gering |
First Address | Oklahoma City, OK 73112-7450 |
Second Address | Midwest City, OK 73110-4860 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/11/2019 |
Last Update Date | 05/11/2019 |