Provider Demographics
NPI:1093381949
Name:CREGAN, NATALLI ISABELLE
Entity Type:Individual
Prefix:
First Name:NATALLI
Middle Name:ISABELLE
Last Name:CREGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 S CREEKDALE DR APT 103
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-5036
Mailing Address - Country:US
Mailing Address - Phone:405-365-4025
Mailing Address - Fax:
Practice Address - Street 1:1018 24TH AVE NW STE 110
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-6556
Practice Address - Country:US
Practice Address - Phone:405-310-5306
Practice Address - Fax:405-310-4934
Is Sole Proprietor?:No
Enumeration Date:2021-06-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician