Provider Demographics
NPI:1023380250
Name:DRENNAN, ALISIA (ALI) LEANNE (MED)
Entity Type:Individual
Prefix:
First Name:ALISIA (ALI)
Middle Name:LEANNE
Last Name:DRENNAN
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 LANDSDOWNE DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-4213
Mailing Address - Country:US
Mailing Address - Phone:405-613-4520
Mailing Address - Fax:
Practice Address - Street 1:1650 W TECUMSEH RD
Practice Address - Street 2:STE 500
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-8271
Practice Address - Country:US
Practice Address - Phone:405-321-0240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-03
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health