Provider Demographics
NPI:1386755148
Name:PREISZ, MELVYN (PHD)
Entity type:Individual
Prefix:
First Name:MELVYN
Middle Name:
Last Name:PREISZ
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3629 NW 51ST ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-5610
Mailing Address - Country:US
Mailing Address - Phone:405-601-0954
Mailing Address - Fax:405-601-3750
Practice Address - Street 1:3629 NW 51ST ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-5610
Practice Address - Country:US
Practice Address - Phone:405-601-0954
Practice Address - Fax:405-601-3750
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK132103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical