Provider Demographics
NPI:1083634158
Name:SPRADLIN, JANET (PHD)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:
Last Name:SPRADLIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23301 BOB WHITE DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73003-9443
Mailing Address - Country:US
Mailing Address - Phone:405-272-6554
Mailing Address - Fax:405-231-8759
Practice Address - Street 1:1000 N LEE AVE
Practice Address - Street 2:ROOM 6188
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73102-1036
Practice Address - Country:US
Practice Address - Phone:405-272-6554
Practice Address - Fax:405-231-8759
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK674103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKS89362Medicare UPIN