Healthcare Provider Details

I. General information

NPI: 1598087256
Provider Name (Legal Business Name): HEIDI J. H. KAMM PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2010
Last Update Date: 02/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 W MAIN ST STE 102
NORMAN OK
73069-6824
US

IV. Provider business mailing address

1225 W MAIN ST STE 102
NORMAN OK
73069-6824
US

V. Phone/Fax

Practice location:
  • Phone: 405-292-1000
  • Fax: 405-801-2506
Mailing address:
  • Phone: 405-292-1000
  • Fax: 405-801-2506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number1077
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: