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Individual

DR. BRIAN JOHN BIGELOW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D., ABPP

Contact information

Practice address
813 SW B AVE, LAWTON, OK 73501-3954
(580) 482-3900
(580) 248-1987
Mailing address
BOX 458 20 RIDEAU AVE., CONISTON, ONTARIO P0M1M-0
(705) 694-5719

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
995
OK
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
995
ZZ

Other

Enumeration date
02/22/2012
Last updated
02/22/2012
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