Individual
DR. JANET GAYLE WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
4815 S HARVARD AVE, SUITE 525, TULSA, OK 74135-3055
(918) 619-9060
(918) 289-0436
Mailing address
4815 S HARVARD AVE, SUITE 525, TULSA, OK 74135-3055
(918) 619-9060
(918) 289-0436
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
566
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100839210B
—
OK
05
—
10083921A
—
OK
01
—
600522417
MEDICARE PTAN
OK
Enumeration date
07/20/2006
Last updated
08/06/2015
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