Provider Demographics
NPI:1932278942
Name:SIGURDSON, MARION K (PHD)
Entity Type:Individual
Prefix:
First Name:MARION
Middle Name:K
Last Name:SIGURDSON
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 1:3150 E 41ST ST
Mailing Address - Street 2:SUITE 107
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-3717
Mailing Address - Country:US
Mailing Address - Phone:918-949-3533
Mailing Address - Fax:
Practice Address - Street 1:3150 E 41ST ST
Practice Address - Street 2:SUITE 107
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-3717
Practice Address - Country:US
Practice Address - Phone:918-949-3533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK305103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling