Individual
REGINA SIOUX ERTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
2307 GORDON COOPER DR, SHAWNEE, OK 74801-9007
(405) 214-5101
(405) 878-5846
Mailing address
2307 GORDON COOPER DR, SHAWNEE, OK 74801-9007
(405) 214-5101
(405) 878-5846
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1319
OK
Other
Enumeration date
09/25/2018
Last updated
09/25/2018
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