MEDICARE: DANIEL GERING, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	103TC0700X	Clinical Psychologist
2	103TH0100X	Health Service Psychologist
3	103TM1800X	Intellectual & Developmental Disabilities Psychologist
4	103TC2200X	Clinical Child & Adolescent Psychologist

General Provider Information

NPI Number	:	1639988025
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DANIEL GERING, LLC

Provider Business Mailing Address
First Line	:	4001 N CLASSEN BLVD STE 230
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73118-2643
Country	:	US
Telephone Number	:	405-367-9354
Fax Number	:	405-930-5432

Provider Business Practice Location Address
First Line	:	4001 N CLASSEN BLVD STE 230
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73118-2643
Country	:	US
Telephone Number	:	405-367-9354
Fax Number	:	405-930-5432

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DANIEL LAWRENCE GERING
Credential	:	PHD
Telephone Number	:	405-367-9354

Provider Enumeration Date	:	12/31/2024
Last Update Date	:	12/31/2024

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