Healthcare Provider Details

I. General information

NPI: 1295754646
Provider Name (Legal Business Name): NANCY HIATT DILLEY PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 24TH AVE SW
NORMAN OK
73069-5106
US

IV. Provider business mailing address

510 24TH AVE SW
NORMAN OK
73069-5106
US

V. Phone/Fax

Practice location:
  • Phone: 405-329-7923
  • Fax: 405-329-8815
Mailing address:
  • Phone: 405-329-7923
  • Fax: 405-329-8815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number567
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: