Provider Demographics
NPI:1639256951
Name:RINEER, MARY ELIZABETH (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:ELIZABETH
Last Name:RINEER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3311 E 46TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-2903
Mailing Address - Country:US
Mailing Address - Phone:918-747-8282
Mailing Address - Fax:918-747-6601
Practice Address - Street 1:3311 E 46TH ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-2903
Practice Address - Country:US
Practice Address - Phone:918-747-8282
Practice Address - Fax:918-747-6601
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK583103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKFEDERAL TAX IDOtherFEDERAL TAX ID
OK100837410AMedicaid
OKFEDERAL TAX IDOtherFEDERAL TAX ID