Individual
DR. MERRIE MICHAL ELISENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
222 OLIPHANT AVE, SUITE 230, NORMAN, OK 73026-3701
(405) 329-8454
(405) 360-8193
Mailing address
2420 SPRINGER DR, SUITE 230, NORMAN, OK 73069-3965
(405) 329-8454
(405) 360-8193
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
833
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100837710-A
—
OK
01
—
189327
TRICARE
OK
Enumeration date
01/13/2007
Last updated
01/23/2017
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