Provider Demographics
NPI:1326220815
Name:JANET WILLIS PHD PC INC
Entity Type:Organization
Organization Name:JANET WILLIS PHD PC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:918-640-2632
Mailing Address - Street 1:7146 S BRADEN AVE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-6371
Mailing Address - Country:US
Mailing Address - Phone:918-640-2632
Mailing Address - Fax:918-488-8021
Practice Address - Street 1:7146 S BRADEN AVE
Practice Address - Street 2:SUITE 500
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-6371
Practice Address - Country:US
Practice Address - Phone:918-640-2632
Practice Address - Fax:918-488-8021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-27
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty