Organization
JONATHAN D CARGILL, PHD, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN DALE CARGILL PHD (PRESIDENT)
(405) 598-3668
Entity
Organization
Contact information
Practice address
23 E 9TH ST, SUITE 311, SHAWNEE, OK 74801-6943
(405) 275-6701
(405) 598-3668
Mailing address
PO BOX 114, TECUMSEH, OK 74873-0114
(405) 598-3668
(405) 598-0338
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
300
OK
Other
Enumeration date
01/16/2008
Last updated
01/16/2008
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