Healthcare Provider Details

I. General information

NPI: 1871346957
Provider Name (Legal Business Name): DR. RENEE L. ALLEN, PSYCHOLOGIST, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2024
Last Update Date: 05/07/2024
Certification Date: 05/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2448 E 81ST ST STE 2300
TULSA OK
74137-4279
US

IV. Provider business mailing address

2448 E 81ST ST STE 2300
TULSA OK
74137-4279
US

V. Phone/Fax

Practice location:
  • Phone: 918-728-3032
  • Fax:
Mailing address:
  • Phone: 918-728-3032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: SHANNON PILKERTON
Title or Position: BILLER
Credential:
Phone: 918-512-1773