Healthcare Provider Details

I. General information

NPI: 1689085011
Provider Name (Legal Business Name): DAVID DELKER LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2014
Last Update Date: 12/23/2021
Certification Date: 12/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33007 45TH ST
SHAWNEE OK
74804-3429
US

IV. Provider business mailing address

6206 NW CHERRY AVE
LAWTON OK
73505-4429
US

V. Phone/Fax

Practice location:
  • Phone: 405-214-0116
  • Fax: 877-334-8552
Mailing address:
  • Phone: 580-695-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1386
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: