Provider Demographics
NPI:1285678516
Name:HAKMAN, MELISSA A (PHD)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:A
Last Name:HAKMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:MELISSA
Other - Middle Name:A
Other - Last Name:HAKMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:1100 NE 13TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73117-1039
Mailing Address - Country:US
Mailing Address - Phone:405-271-5700
Mailing Address - Fax:405-271-8835
Practice Address - Street 1:1100 NE 13TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73117-1039
Practice Address - Country:US
Practice Address - Phone:405-271-5700
Practice Address - Fax:405-271-8835
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1100103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000375745OtherBLUE CROSS & BLUE SHIELD
KY812558000OtherMAGELLAN BEHAVORIAL HEALT