Provider Demographics
NPI:1225323058
Name:THORSON PHD PC
Entity Type:Organization
Organization Name:THORSON PHD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DARLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:THORSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:405-290-1411
Mailing Address - Street 1:PO BOX 721591
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73070-8222
Mailing Address - Country:US
Mailing Address - Phone:405-290-1411
Mailing Address - Fax:405-290-1450
Practice Address - Street 1:1800 N INTERSTATE DR
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-2993
Practice Address - Country:US
Practice Address - Phone:405-290-1411
Practice Address - Fax:405-290-1450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK964103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty