Provider Demographics
NPI:1902004237
Name:OGLETREE, MARK DRYDEN (MA, PHD, LPC)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:DRYDEN
Last Name:OGLETREE
Suffix:
Gender:M
Credentials:MA, PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4829 CEDAR CREST DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-7758
Mailing Address - Country:US
Mailing Address - Phone:972-569-8176
Mailing Address - Fax:
Practice Address - Street 1:4829 CEDAR CREST DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-7758
Practice Address - Country:US
Practice Address - Phone:972-569-8176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19816101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health