Provider Demographics
NPI:1598957938
Name:NEUROPSYCHOLOGY ASSOCIATES
Entity Type:Organization
Organization Name:NEUROPSYCHOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/NEUROPSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICKEY
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:OZOLINS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:405-749-2870
Mailing Address - Street 1:4140 W MEMORIAL RD
Mailing Address - Street 2:SUITE 601
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-8366
Mailing Address - Country:US
Mailing Address - Phone:405-749-2870
Mailing Address - Fax:405-749-2858
Practice Address - Street 1:4140 W MEMORIAL RD
Practice Address - Street 2:SUITE 601
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-8366
Practice Address - Country:US
Practice Address - Phone:405-749-2870
Practice Address - Fax:405-749-2858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-09
Last Update Date:2009-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK=========Medicare PIN