Healthcare Provider Details

I. General information

NPI: 1013320241
Provider Name (Legal Business Name): KAREN SUE GREENFIELD ED.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2014
Last Update Date: 06/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3005 NW 63RD ST
OKLAHOMA CITY OK
73116-3603
US

IV. Provider business mailing address

3005 NW 63RD ST
OKLAHOMA CITY OK
73116-3603
US

V. Phone/Fax

Practice location:
  • Phone: 405-521-1755
  • Fax: 405-521-1138
Mailing address:
  • Phone: 405-521-1755
  • Fax: 405-521-1138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: