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NPI Code Detail

MEDICARE: MRS. MICHELLE LYNN STINNETT

MEDICARE:  MRS. MICHELLE LYNN STINNETT
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
1103T00000XPsychologist

General Provider Information

NPI Number : 1508200494
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MICHELLE LYNN STINNETT
Provider Business Mailing Address
First Line : 2520 ARLINGTON BLVD
Second Line :
City : ADA
State : OK
Zip : 74820-4622
Country : US
Telephone Number : 580-235-7508
Fax Number :
Provider Business Practice Location Address
First Line : 2520 ARLINGTON BLVD
Second Line :
City : ADA
State : OK
Zip : 74820-4622
Country : US
Telephone Number : 580-235-7508
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2013
Last Update Date : 04/22/2013

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Directions to “ MRS. MICHELLE LYNN STINNETT ” Practice Location

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