Provider Demographics
NPI:1790021780
Name:BELDEN, DUSTIN NEIL
Entity Type:Individual
Prefix:
First Name:DUSTIN
Middle Name:NEIL
Last Name:BELDEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1621 GREY FOX RUN
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73131-1219
Mailing Address - Country:US
Mailing Address - Phone:405-474-7563
Mailing Address - Fax:
Practice Address - Street 1:1621 GREY FOX RUN
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73131-1219
Practice Address - Country:US
Practice Address - Phone:405-474-7563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-18
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst