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NPI Code Detail

MEDICARE: DR. PAMELA ANN VROOMAN PH.D.

MEDICARE: DR. PAMELA ANN VROOMAN PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist1056OK

General Provider Information

NPI Number : 1548448608
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAMELA ANN VROOMAN PH.D.
Provider Business Mailing Address
First Line : 2524 E 20TH ST
Second Line :
City : TULSA
State : OK
Zip : 74104-5810
Country : US
Telephone Number : 918-743-6255
Fax Number : 918-743-0649
Provider Business Practice Location Address
First Line : 1608 S ELWOOD AVE
Second Line :
City : TULSA
State : OK
Zip : 74119-4208
Country : US
Telephone Number : 918-587-3888
Fax Number : 918-587-3891
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2008
Last Update Date : 01/31/2008

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