Healthcare Provider Details

I. General information

NPI: 1821118316
Provider Name (Legal Business Name): ALICIA K PRITCHARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 02/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2113 SW 65TH ST
OKLAHOMA CITY OK
73159-2921
US

IV. Provider business mailing address

2113 SW 65TH ST
OKLAHOMA CITY OK
73159-2921
US

V. Phone/Fax

Practice location:
  • Phone: 405-694-8438
  • Fax: 405-691-9205
Mailing address:
  • Phone: 405-694-8438
  • Fax: 405-691-9205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: