MEDICARE: DR. EMILY M CHOQUETTE PHD

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
1	103TC0700X	Clinical Psychologist	1450	OK

General Provider Information

NPI Number	:	1710707484
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EMILY M CHOQUETTE PHD

Provider Business Mailing Address
First Line	:	4160 S ROCKFORD PL
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74105-4046
Country	:	US
Telephone Number	:	301-233-5367
Fax Number	:

Provider Business Practice Location Address
First Line	:	4160 S ROCKFORD PL
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74105-4046
Country	:	US
Telephone Number	:	301-233-5367
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/16/2024
Last Update Date	:	10/16/2024

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Directions to “ DR. EMILY M CHOQUETTE PHD” Practice Location

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