Provider Demographics
NPI:1649396649
Name:WINTEROWD, CARRIE L (PHD)
Entity Type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:L
Last Name:WINTEROWD
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 1:2128 TANGLEWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74074-1711
Mailing Address - Country:US
Mailing Address - Phone:405-612-6002
Mailing Address - Fax:
Practice Address - Street 1:409 WILLARD HALL
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74078-1001
Practice Address - Country:US
Practice Address - Phone:405-612-6002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK762103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling