Provider Demographics
NPI:1144652132
Name:CARGILE, FELISA
Entity type:Individual
Prefix:MRS
First Name:FELISA
Middle Name:
Last Name:CARGILE
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 1:1218 NW 83RD ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73114-1514
Mailing Address - Country:US
Mailing Address - Phone:405-842-1749
Mailing Address - Fax:
Practice Address - Street 1:1218 NW 83RD ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73114-1514
Practice Address - Country:US
Practice Address - Phone:405-842-1749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-01
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral