MEDICARE: DR. DENA PINSON PH.D.

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
1	103TH0100X	Health Service Psychologist	934	OK
2	103TS0200X	School Psychologist	934	OK
3	103T00000X	Psychologist	934	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	934	OTHER	OK	OKLAHOMA STATE BOARD OF EXAMINERS OF PSYCHOLOGISTS
2	12525097	OTHER	OK	CAQH
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437361847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENA PINSON PH.D.

Provider Business Mailing Address
First Line	:	PO BOX 31331
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73003-0023
Country	:	US
Telephone Number	:	405-620-3499
Fax Number	:

Provider Business Practice Location Address
First Line	:	5500 N WESTERN AVE STE 157
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73118-4018
Country	:	US
Telephone Number	:	405-510-0850
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/06/2007
Last Update Date	:	06/08/2019

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