Provider Demographics
NPI:1134199292
Name:CHONEY, SANDRA KAYE (PHD)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:KAYE
Last Name:CHONEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MISS
Other - First Name:SANDRA
Other - Middle Name:KAYE
Other - Last Name:B ENNETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2401 W WRANGLER BLVD
Mailing Address - Street 2:
Mailing Address - City:SEMINOLE
Mailing Address - State:OK
Mailing Address - Zip Code:74868-1917
Mailing Address - Country:US
Mailing Address - Phone:405-303-4167
Mailing Address - Fax:405-303-4156
Practice Address - Street 1:2401 W WRANGLER BLVD
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:OK
Practice Address - Zip Code:74868-1917
Practice Address - Country:US
Practice Address - Phone:405-303-4167
Practice Address - Fax:405-303-4156
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-23
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK694103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100840220BMedicaid
OK100840220BMedicaid