Healthcare Provider Details

I. General information

NPI: 1770994170
Provider Name (Legal Business Name): GAYLE L FLYNN EDD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2014
Last Update Date: 05/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3344 NE 14TH ST
OKLAHOMA CITY OK
73117-6206
US

IV. Provider business mailing address

105 N CARRIE LN
OKLAHOMA CITY OK
73117-8412
US

V. Phone/Fax

Practice location:
  • Phone: 405-427-0918
  • Fax:
Mailing address:
  • Phone: 405-427-0918
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1744R1102X
TaxonomyResearch Study Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: