Provider Demographics
NPI:1265131106
Name:TROUPE, TAKELIA
Entity type:Individual
Prefix:
First Name:TAKELIA
Middle Name:
Last Name:TROUPE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1907 OAKHURST CIR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-1628
Mailing Address - Country:US
Mailing Address - Phone:405-209-4633
Mailing Address - Fax:
Practice Address - Street 1:1907 OAKHURST CIR
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-1628
Practice Address - Country:US
Practice Address - Phone:405-209-4633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist