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General NPI Number Information
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NPI Number | 1821449497
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Entity Type | Organization
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Legal Business Name | UKPSYCH LLC
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Dates
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Enumeration Date | 06/24/2016
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Last Update Date | 01/13/2020
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Provider Practice Location Address
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Address Line | 8988 S SHERIDAN RD STE D2
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City | TULSA
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State | OK
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Zip | 74133-5035
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Country | US
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Telephone | 970-834-8610
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Fax | 844-308-5898
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Provider Business Mailing Address
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Address Line | 8988 S SHERIDAN RD STE D2
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City | TULSA
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State | OK
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Zip | 74133-5035
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Country | US
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Telephone | 970-834-8610
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Fax | 844-308-5898
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. KATRINA MARIA CRADER
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Credential | M.D.
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Telephone | 970-834-8610
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 29081
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License Number State | OK
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