Provider Demographics
NPI:1558610246
Name:CHRISMAN, MICHELINE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MICHELINE
Middle Name:
Last Name:CHRISMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 W MAIN ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-6824
Mailing Address - Country:US
Mailing Address - Phone:405-310-3561
Mailing Address - Fax:
Practice Address - Street 1:1225 W MAIN ST
Practice Address - Street 2:SUITE 102
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-6824
Practice Address - Country:US
Practice Address - Phone:405-310-3561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-10
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1158103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical