NPI 1003074741

Caleb Wayne Lack, PHD

Practitioner Clinical Psychologist Edmond, OK

Practice location

Address: 7413 Oak Ave, Edmond, OK 73034-9058
Phone: (405) 509-0959

Registered specialties (2)

Clinical Psychologist Primary

Behavioral Health & Social Service Providers Taxonomy 103TC0700X Licence 1143 (OK)

Other Psychologist providers in Oklahoma →

Clinical Psychologist

Behavioral Health & Social Service Providers Taxonomy 103TC0700X Licence 07-37P (AR)

Registry record

NPI: 1003074741
Entity type: Individual
Sex (as registered): Male
NPI issued: 29 May 2008
Record last updated: 21 Mar 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.