Provider Demographics
NPI:1053458794
Name:CENTER FOR NEUROBEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:CENTER FOR NEUROBEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL NEUROPSYCHOLOGISTOWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:HARTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:405-692-3353
Mailing Address - Street 1:10443 N MAY AVE
Mailing Address - Street 2:STE 621
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-2610
Mailing Address - Country:US
Mailing Address - Phone:405-692-3353
Mailing Address - Fax:405-692-3362
Practice Address - Street 1:10021 S WESTERN AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-2927
Practice Address - Country:US
Practice Address - Phone:405-692-3353
Practice Address - Fax:405-692-3362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKOP989103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty