| Doctor Name: | ANNA M HOMEN |
| NPI Number: | 1134452600 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | 1252 |
| Business Practice Address: | 1044 Sw 4th St Moore, OK - 731602405 |
| Business Phone Number: | 4057356333 |
| Business Fax Number: | 4057356629 |
| Mailing Address: | 1044 Sw 4th St, MOORE |
| State: | OK |
| Postal Code: | 731602405 |
| Phone Number: | 4057356333 |
| Fax Number: | 4057356629 |
| NPI Enumeration Date: | 09/15/2009 |
| NPI Last Update Date: | 01/01/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC2200X |
| License Number: | 1252 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical Child & Adolescent |
| Taxonomy Definition: | |