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General NPI Number Information
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NPI Number | 1225323058
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Entity Type | Organization
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Legal Business Name | THORSON PHD PC
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Dates
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Enumeration Date | 06/09/2011
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Last Update Date | 06/09/2011
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Provider Practice Location Address
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Address Line | 1800 N INTERSTATE DR
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City | NORMAN
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State | OK
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Zip | 73072-2993
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Country | US
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Telephone | 405-290-1411
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Fax | 405-290-1450
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Provider Business Mailing Address
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Address Line | PO BOX 721591
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City | NORMAN
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State | OK
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Zip | 73070-8222
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Country | US
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Telephone | 405-290-1411
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Fax | 405-290-1450
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. DARLINE THORSON
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Credential | PH.D.
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Telephone | 405-290-1411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 964
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License Number State | OK
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