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Individual

DR. RICHARAD ALLYN WALTON JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
5110 S YALE AVE, SUITE 103, TULSA, OK 74135-7401
(918) 779-7637
(918) 938-6037
Mailing address
5110 S YALE AVE, SUITE 103, TULSA, OK 74135-7401
(918) 779-7637
(918) 938-6037

Taxonomy

Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
508
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100840000A
OK
Enumeration date
06/27/2006
Last updated
06/28/2008
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