Provider Demographics
NPI:1720370406
Name:CONGER, RITA KAE (PHD)
Entity Type:Individual
Prefix:DR
First Name:RITA
Middle Name:KAE
Last Name:CONGER
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:PO BOX 548
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:OK
Mailing Address - Zip Code:73051-0548
Mailing Address - Country:US
Mailing Address - Phone:405-527-4878
Mailing Address - Fax:405-527-4874
Practice Address - Street 1:16161 MOFFAT ROAD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:OK
Practice Address - Zip Code:73051
Practice Address - Country:US
Practice Address - Phone:405-527-4878
Practice Address - Fax:405-527-4874
Is Sole Proprietor?:No
Enumeration Date:2011-05-12
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1033103TC1900X, 103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling