Provider Demographics
NPI:1841369097
Name:MOBLEY, DIANA GAIL (PHD)
Entity type:Individual
Prefix:DR
First Name:DIANA
Middle Name:GAIL
Last Name:MOBLEY
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 1:1809 ROBIN RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-2867
Mailing Address - Country:US
Mailing Address - Phone:405-360-2274
Mailing Address - Fax:
Practice Address - Street 1:2424 SPRINGER DR
Practice Address - Street 2:SUITE 102
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-3966
Practice Address - Country:US
Practice Address - Phone:405-360-2274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK461103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling