Provider Demographics
NPI:1942494448
Name:DANAHER, ROBERT ANDREW (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ANDREW
Last Name:DANAHER
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 1:6125 W. RENO AVENUE
Mailing Address - Street 2:SUITE 900
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73127
Mailing Address - Country:US
Mailing Address - Phone:405-422-2902
Mailing Address - Fax:405-422-2802
Practice Address - Street 1:6125 W. RENO AVENUE
Practice Address - Street 2:SUITE 900
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73127
Practice Address - Country:US
Practice Address - Phone:405-422-2902
Practice Address - Fax:405-422-2802
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-29
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK799103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical