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NPI Code Detail

MEDICARE: DR. DENISE M DART PSYD

MEDICARE:  DR. DENISE M DART  PSYD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TA0400XAddiction (Substance Use Disorder) Psychologist4169AZ
2103TC2200XClinical Child & Adolescent Psychologist4169AZ
3103TC0700XClinical Psychologist4169AZ

General Provider Information

NPI Number : 1255638904
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DENISE M DART PSYD
Provider Business Mailing Address
First Line : 1205 S UMBRELLA AVE
Second Line :
City : BROKEN ARROW
State : OK
Zip : 74012-4569
Country : US
Telephone Number : 602-885-5026
Fax Number :
Provider Business Practice Location Address
First Line : 2321 E 3RD ST
Second Line :
City : TULSA
State : OK
Zip : 74104-1831
Country : US
Telephone Number : 918-622-0641
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2011
Last Update Date : 07/21/2022

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Directions to “ DR. DENISE M DART PSYD” Practice Location

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