Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | ||
Y | 103G00000X | Clinical Psychologist | 095250 | IA |
Y | 103TC0700X | Clinical Psychologist | 095250 | IA |
N | 103TP0814X | Psychoanalysis | ||
N | 103TP2701X | Group Psychotherapist |
NPI | 1508425042 |
---|---|
Provider Name | Dr. Samantha Danielle Price |
First Address | Oklahoma City, OK 73104-5007 |
Second Address | Oklahoma City, OK 73104-5007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2019 |
Last Update Date | 09/06/2019 |