Provider Demographics
NPI:1407102742
Name:NORMAN NEUROPSYCHOLOGY ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:NORMAN NEUROPSYCHOLOGY ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL NEUROPSYCHOLOGIST/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:F
Authorized Official - Last Name:LINCK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:405-818-7768
Mailing Address - Street 1:3280 MARSHALL AVE
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-8022
Mailing Address - Country:US
Mailing Address - Phone:405-818-7768
Mailing Address - Fax:
Practice Address - Street 1:3280 MARSHALL AVE
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-8022
Practice Address - Country:US
Practice Address - Phone:405-818-7768
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-24
Last Update Date:2012-11-02
Deactivation Date:2012-08-17
Deactivation Code:
Reactivation Date:2012-11-02
Provider Licenses
StateLicense IDTaxonomies
OK1147103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty