Provider Demographics
NPI:1043221872
Name:TRAPP, MARIA (PHD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:TRAPP
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:TRAPP-BRALY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:416 W 15TH ST
Mailing Address - Street 2:BUILDING 500, SUITE E
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-3747
Mailing Address - Country:US
Mailing Address - Phone:405-726-2745
Mailing Address - Fax:405-726-2746
Practice Address - Street 1:416 W 15TH ST
Practice Address - Street 2:BUILDING 500, SUITE E
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-3747
Practice Address - Country:US
Practice Address - Phone:405-726-2745
Practice Address - Fax:405-726-2746
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2012-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK846103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK243434201Medicare ID - Type Unspecified