Provider Demographics
NPI:1174689509
Name:SWEET, ALLEN WAYNE (PHD)
Entity Type:Individual
Prefix:
First Name:ALLEN
Middle Name:WAYNE
Last Name:SWEET
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5151 E 51ST ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-7457
Mailing Address - Country:US
Mailing Address - Phone:918-622-8494
Mailing Address - Fax:918-622-8495
Practice Address - Street 1:5151 E 51ST ST
Practice Address - Street 2:SUITE 103
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-7457
Practice Address - Country:US
Practice Address - Phone:918-622-8494
Practice Address - Fax:918-622-8495
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK197103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical