Provider Demographics
NPI:1386936516
Name:GEETER, GREG LYNN II
Entity type:Individual
Prefix:MR
First Name:GREG
Middle Name:LYNN
Last Name:GEETER
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2616 N ANN ARBOR AVE
Mailing Address - Street 2:APT 120
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73127-1848
Mailing Address - Country:US
Mailing Address - Phone:405-414-6043
Mailing Address - Fax:
Practice Address - Street 1:2616 N ANN ARBOR AVE
Practice Address - Street 2:APT 120
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73127-1848
Practice Address - Country:US
Practice Address - Phone:405-414-6043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-05
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst