Organization
COMMUNITY PATHWAYS UNLIMITED INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA KAY DYER (DIRECTOR OF OPERATINS)
(405) 842-4911
Entity
Organization
Contact information
Practice address
4045 NW 64TH ST, STE 520, OKLAHOMA CITY, OK 73116-8608
(405) 842-4911
Mailing address
4045 NW 64TH ST, STE 520, OKLAHOMA CITY, OK 73116-8608
(405) 842-4911
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
260
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100744820A
—
OK
01
—
442366315001
OUTPT MENTAL HEALTH
OK
01
—
DD4662
RAILROAD MEDICARE
OK
Enumeration date
05/28/2006
Last updated
10/26/2022
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