Provider Demographics
NPI:1689739344
Name:COCHRAN, RANDY LYNN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:RANDY
Middle Name:LYNN
Last Name:COCHRAN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 E MEMORIAL RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-6474
Mailing Address - Country:US
Mailing Address - Phone:405-627-9636
Mailing Address - Fax:405-425-5251
Practice Address - Street 1:2801 E MEMORIAL RD
Practice Address - Street 2:SUITE 102
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-6474
Practice Address - Country:US
Practice Address - Phone:405-627-9636
Practice Address - Fax:405-425-5251
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK798103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical