Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 1269 | OK |
Y | 103TC0700X | Clinical Psychologist | 1269 | OK |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 1269 | OK |
N | 103TH0100X | Health Service | 1269 | OK |
NPI | 1063969897 |
---|---|
Provider Name | Dr. Gabrielle Toloza |
First Address | Oklahoma City, OK 73116-4226 |
Second Address | Oklahoma City, OK 73116-3632 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2016 |
Last Update Date | 09/09/2016 |