Provider Demographics
NPI:1497837017
Name:THRASH, LEE A (PHD)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:A
Last Name:THRASH
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 1:407 W 15TH ST
Mailing Address - Street 2:STE. 7
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-3745
Mailing Address - Country:US
Mailing Address - Phone:405-408-4849
Mailing Address - Fax:
Practice Address - Street 1:407 W 15TH ST
Practice Address - Street 2:STE. 7
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-3745
Practice Address - Country:US
Practice Address - Phone:405-408-4849
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2014-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1092103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service