MEDICARE: DR. MARK SNEED 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
1	103TC1900X	Counseling Psychologist	787	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7278124	OTHER	OK	AETNA
2	23727800173120A019	OTHER	OK	TRICARE

General Provider Information

NPI Number	:	1952359663
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK SNEED PH.D.

Provider Business Mailing Address
First Line	:	13301 N MERIDIAN AVE
Second Line	:	BLDG 100
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-9369
Country	:	US
Telephone Number	:	405-752-9500
Fax Number	:	405-752-9571

Provider Business Practice Location Address
First Line	:	13301 N MERIDIAN AVE
Second Line	:	BLDG 100
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-9369
Country	:	US
Telephone Number	:	405-752-9500
Fax Number	:	405-752-9571

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

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. MARK SNEED PH.D.” Practice Location

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