Provider Demographics
NPI:1730494394
Name:ENGLANDER, MARK ROBERT (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:ROBERT
Last Name:ENGLANDER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 W MAIN ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-6330
Mailing Address - Country:US
Mailing Address - Phone:405-366-7023
Mailing Address - Fax:
Practice Address - Street 1:2550 W MAIN ST
Practice Address - Street 2:SUITE 206
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-6330
Practice Address - Country:US
Practice Address - Phone:405-366-7023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-07
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKLBP0165101Y00000X
OK537103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor