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General NPI Number Information
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NPI Number | 1669521217
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Entity Type | Organization
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Legal Business Name | DENNIS J. MORAN, PH.D. PC
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 02/25/2009
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Provider Practice Location Address
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Address Line | 1601 SW 89TH ST SUITE B-100
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City | OKLAHOMA CITY
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State | OK
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Zip | 73159-6349
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Country | US
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Telephone | 405-681-1227
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Fax | 405-681-1228
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Provider Business Mailing Address
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Address Line | 1601 SW 89TH ST SUITE B-100
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City | OKLAHOMA CITY
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State | OK
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Zip | 73159-6349
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Country | US
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Telephone | 405-681-1227
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Fax | 405-681-1228
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. DENNIS J. MORAN
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Credential | PH.D.
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Telephone | 405-681-1227
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 463
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License Number State | OK
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