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Organization

TULSA PROFESSIONAL PSYCHOLOGY, PLLC

Active
Other names
Green Country Psychology
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TIMOTHY DOTY PSY.D. (CO-PRESIDENT)
(918) 878-8072
Entity
Organization

Contact information

Practice address
3144 S WINSTON AVE STE A, TULSA, OK 74135-2012
(918) 878-8072
(918) 878-8072
Mailing address
1745 S CANTON AVE, TULSA, OK 74112-6937
(918) 878-8072

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
1118
OK
103TC0700X
Clinical Psychologist
1225
OK
103TF0200X
Forensic Psychologist
1118
OK
103TH0100X
Health Service Psychologist
Primary
1118
OK
103TH0100X
Health Service Psychologist
1225
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200460890B
OK
05
200466160A
OK
Enumeration date
05/18/2018
Last updated
05/18/2018
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