Provider Demographics
NPI:1154450922
Name:DAVES, MICHAEL FRANK (PHD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:FRANK
Last Name:DAVES
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 W LINDSEY ST
Mailing Address - Street 2:SUITE C-120
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-4159
Mailing Address - Country:US
Mailing Address - Phone:405-366-8828
Mailing Address - Fax:405-325-1478
Practice Address - Street 1:1818 W LINDSEY ST
Practice Address - Street 2:SUITE C-120
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-4159
Practice Address - Country:US
Practice Address - Phone:405-366-8828
Practice Address - Fax:405-325-1478
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK493103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK731312559 02Medicare UPIN