Provider Demographics
NPI:1972097228
Name:VRIEZE, ALLISON (PSYD PSYCHOLOGIST)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:VRIEZE
Suffix:
Gender:F
Credentials:PSYD PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1044 SW 4TH ST
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-2405
Mailing Address - Country:US
Mailing Address - Phone:405-735-6333
Mailing Address - Fax:405-735-6629
Practice Address - Street 1:1044 SW 4TH ST
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-2405
Practice Address - Country:US
Practice Address - Phone:405-735-6333
Practice Address - Fax:405-735-6629
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-20
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent