Provider Demographics
NPI:1891961132
Name:MARTINSON, SCOTT MATTHEW
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:MATTHEW
Last Name:MARTINSON
Suffix:
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 1:827 N BERRY RD
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-7545
Mailing Address - Country:US
Mailing Address - Phone:405-292-1747
Mailing Address - Fax:
Practice Address - Street 1:900 E MAIN ST BLDG 52
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-5305
Practice Address - Country:US
Practice Address - Phone:405-573-6463
Practice Address - Fax:405-573-6472
Is Sole Proprietor?:No
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional