| Micheline Wijtenburg Pc Inc | |
|
1225 W Main St Suite 102 Norman OK 73069-6824 | |
| (405) 310-3561 | |
| (405) 310-4052 |
| Full Name | Micheline Wijtenburg Pc Inc |
|---|---|
| Speciality | Psychologist |
| Location | 1225 W Main St, Norman, Oklahoma |
| Authorized Official Name and Position | Micheline Chrisman (PRESIDENT) |
| Authorized Official Contact | 4052921000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Micheline Wijtenburg Pc Inc 1225 W Main St Suite 102 Norman OK 73069-6824 Ph: (405) 310-3561 | Micheline Wijtenburg Pc Inc 1225 W Main St Suite 102 Norman OK 73069-6824 Ph: (405) 310-3561 |
| NPI Number | 1861859373 |
|---|---|
| Provider Enumeration Date | 01/28/2016 |
| Last Update Date | 01/28/2016 |
| Medicare PECOS PAC ID | 7315245750 |
|---|---|
| Medicare Enrollment ID | O20160418002077 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861859373 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 1158 (Oklahoma) | Primary |
| Provider Name | Micheline L Chrisman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558610246 PECOS PAC ID: 1254580657 Enrollment ID: I20120928000283 |
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