Healthcare Provider Details

I. General information

NPI: 1447269717
Provider Name (Legal Business Name): DARREN E BRITZ EDD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 01/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 W GRAY ST
NORMAN OK
73069-7117
US

IV. Provider business mailing address

415 W GRAY ST
NORMAN OK
73069-7117
US

V. Phone/Fax

Practice location:
  • Phone: 405-321-3499
  • Fax: 405-364-5379
Mailing address:
  • Phone: 405-321-3499
  • Fax: 405-364-5379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number579
License Number StateOK

VIII. Authorized Official

Name: DARREN E BRITZ
Title or Position: OWNER
Credential: EDD
Phone: 405-321-3499