Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 486 | OK |
N | 103T00000X | Psychologist | 486 | OK |
N | 103TA0700X | Adult Development & Aging Psychologist | 486 | OK |
N | 103G00000X | Clinical Psychologist | 486 | OK |
N | 103TC0700X | Clinical Psychologist | 486 | OK |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 486 | OK |
N | 103TM1800X | Intellectual & Developmental Disabilities | 486 | OK |
N | 103TP2701X | Group Psychotherapist | 486 | OK |
N | 103TR0400X | Rehabilitation Psychologist | 486 | OK |
NPI | 1669588356 |
---|---|
Provider Name | Dr. Patrick J Mason |
First Address | Oklahoma City, OK 73120-2438 |
Second Address | Oklahoma City, OK 73120-2438 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2006 |
Last Update Date | 08/07/2007 |