Provider Demographics
NPI:1699864165
Name:GAY, NORENE WHITEHEAD (PHD)
Entity type:Individual
Prefix:DR
First Name:NORENE
Middle Name:WHITEHEAD
Last Name:GAY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16314 E DAKOTA RD
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017-4498
Mailing Address - Country:US
Mailing Address - Phone:918-232-1587
Mailing Address - Fax:918-341-4399
Practice Address - Street 1:3314 E 51ST ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-3583
Practice Address - Country:US
Practice Address - Phone:918-232-1587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK911103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist