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Behavioral Analyst

Poteau, Oklahoma

Provider NPI: 1063748689

Provider Information:
Gender: F
Sole Proprietor

Practice Location:
Tel: 918-647-9629  Fax: --

Business Mailing Address:
Tel: 918-721-4191  Fax: --

Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Y101YM0800XBehavioral Health & Social Service Providers
Mental Health

Other Provider Identifiers:

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin


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