Provider Demographics
NPI:1174812820
Name:DAY, DAGNE E (BS, BHRS)
Entity type:Individual
Prefix:
First Name:DAGNE
Middle Name:E
Last Name:DAY
Suffix:
Gender:F
Credentials:BS, BHRS
Other - Prefix:
Other - First Name:DAGNE
Other - Middle Name:DAY
Other - Last Name:NEWCOMB
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BS, BHRS
Mailing Address - Street 1:2204 NE 18TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73111-1706
Mailing Address - Country:US
Mailing Address - Phone:405-812-5890
Mailing Address - Fax:
Practice Address - Street 1:1330 N CLASSEN BLVD
Practice Address - Street 2:SUITE 315
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73106-6835
Practice Address - Country:US
Practice Address - Phone:405-631-1810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-04
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health