Provider Demographics
NPI:1356459523
Name:KILPATRICK, CHERYL ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:ANN
Last Name:KILPATRICK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:3223 EAST 31ST STREET
Mailing Address - Street 2:STE 201
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-2444
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4870 S LEWIS AVE
Practice Address - Street 2:STE 230
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-5151
Practice Address - Country:US
Practice Address - Phone:918-749-6935
Practice Address - Fax:918-749-7611
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-28
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK279103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical