MEDICARE: DR. SEAN WEST FERRELL 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	103T00000X	Psychologist

General Provider Information

NPI Number	:	1942246228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SEAN WEST FERRELL PH.D

Provider Business Mailing Address
First Line	:	5300 N INDEPENDENCE AVE
Second Line	:	280
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-5556
Country	:	US
Telephone Number	:	405-604-3170
Fax Number	:	405-948-2745

Provider Business Practice Location Address
First Line	:	5100 N BROOKLINE AVE
Second Line	:	950
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-3623
Country	:	US
Telephone Number	:	405-604-3170
Fax Number	:	405-948-2745

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

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	03/23/2018

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