Healthcare Provider Details

I. General information

NPI: 1487900858
Provider Name (Legal Business Name): MARY C UNDERHILL PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2012
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

712 WALL ST
NORMAN OK
73069-6360
US

IV. Provider business mailing address

4201 FOX CROFT RD
NORMAN OK
73026-0905
US

V. Phone/Fax

Practice location:
  • Phone: 405-579-7560
  • Fax: 405-579-7563
Mailing address:
  • Phone: 954-552-0388
  • Fax: 405-579-7563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number1159
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: