Provider Demographics
NPI:1134472392
Name:CALHOUN, TIMOTHY E
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:E
Last Name:CALHOUN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 SW 93RD ST
Mailing Address - Street 2:APT 104
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-4802
Mailing Address - Country:US
Mailing Address - Phone:405-694-9454
Mailing Address - Fax:
Practice Address - Street 1:505 SW 93RD ST
Practice Address - Street 2:APT 104
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-4802
Practice Address - Country:US
Practice Address - Phone:405-694-9454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-24
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst