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General NPI Number Information
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NPI Number | 1619708161
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Entity Type | Organization
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Legal Business Name | UYM CLINIC PC
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Dates
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Enumeration Date | 08/08/2024
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 1501 S RANCHWOOD BLVD STE 203
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City | YUKON
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State | OK
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Zip | 73099-2758
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Country | US
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Telephone | 405-914-6634
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Fax | 405-914-6693
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Provider Business Mailing Address
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Address Line | 1501 S RANCHWOOD BLVD STE 203
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City | YUKON
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State | OK
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Zip | 73099-2758
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Country | US
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Telephone | 405-914-6634
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Fax |
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Authorized Official
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Title or Position | PMHNP-BC
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Name | MRS. ANGIE MARIE OSBORN
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Credential | APRN
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Telephone | 405-914-6634
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2084P0802X
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Taxonomy Name | Addiction Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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