Organization
OKLAHOMA KIDS PSYCHOLOGICAL SERVICE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIRACLE N GOETZ PSY.D. (LICENSED CLINICAL PSYCHOLOGIST)
(209) 261-4008
Entity
Organization
Contact information
Practice address
937 SW 89TH ST STE C, OKLAHOMA CITY, OK 73139-9231
(405) 339-2245
Mailing address
3035 NW 63RD ST STE 227, OKLAHOMA CITY, OK 73116-3631
(405) 242-6460
(405) 544-5916
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200587910A
—
OK
Enumeration date
10/04/2022
Last updated
04/16/2026
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