Healthcare Provider Details

I. General information

NPI: 1518048529
Provider Name (Legal Business Name): ROLAND LAVELLE PALMER PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1090 N UNIVERSITY BLVD
NORMAN OK
73069-7620
US

IV. Provider business mailing address

1090 N UNIVERSITY BLVD.
NORMAN OK
73069
US

V. Phone/Fax

Practice location:
  • Phone: 405-447-0470
  • Fax: 405-447-7087
Mailing address:
  • Phone: 405-447-0470
  • Fax: 405-447-7087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number640
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: