Provider Demographics
NPI:1801916010
Name:STOCKLEY, DANIEL M (PHD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:M
Last Name:STOCKLEY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 S YALE AVENUE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-7486
Mailing Address - Country:US
Mailing Address - Phone:918-495-0822
Mailing Address - Fax:918-495-0836
Practice Address - Street 1:5200 S YALE AVENUE
Practice Address - Street 2:SUITE 201
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-7486
Practice Address - Country:US
Practice Address - Phone:918-495-0822
Practice Address - Fax:918-495-0836
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK595103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist