Provider Demographics
NPI:1447261755
Name:DORFMAN, KAREN MICHELE (PHD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:MICHELE
Last Name:DORFMAN
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 1:2509 PRESCOTT AVE
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-2917
Mailing Address - Country:US
Mailing Address - Phone:405-285-5378
Mailing Address - Fax:
Practice Address - Street 1:3035 NW 63RD ST
Practice Address - Street 2:SUITE 227
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-3632
Practice Address - Country:US
Practice Address - Phone:405-822-6872
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK979103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist