Provider Demographics
NPI:1427671379
Name:OAKLEY, MARYKATE (PHD)
Entity type:Individual
Prefix:DR
First Name:MARYKATE
Middle Name:
Last Name:OAKLEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1977 MOORE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH ROYALTON
Mailing Address - State:VT
Mailing Address - Zip Code:05068-9584
Mailing Address - Country:US
Mailing Address - Phone:716-913-4421
Mailing Address - Fax:
Practice Address - Street 1:20 WEST ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03766-1290
Practice Address - Country:US
Practice Address - Phone:716-913-4421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-27
Last Update Date:2025-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT048.0135091103TC0700X
NH1540103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical