Provider Demographics
NPI:1992054332
Name:ALLEN, KATIE RHODE (PHD)
Entity type:Individual
Prefix:DR
First Name:KATIE
Middle Name:RHODE
Last Name:ALLEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:KATIE
Other - Middle Name:MANSFIELD
Other - Last Name:RHODE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:724 NW 54TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118-6015
Mailing Address - Country:US
Mailing Address - Phone:806-438-0663
Mailing Address - Fax:
Practice Address - Street 1:3341 CHARDONNAY LN
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-5085
Practice Address - Country:US
Practice Address - Phone:405-701-6006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-30
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4829101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional