Roosevelt Premier Therapy

NPI #1356188692 in Moore, Oklahoma

Provider Information

NPI Number: 1356188692
Entity Type: Organization
Organization Name: Roosevelt Premier Therapy
Primary Specialty: Behavior Analyst
Enumeration Date: Jul 12, 2024
Last Updated: Jul 15, 2024

Practice Location

Address: 1120 N EASTERN AVE STE 108
City: Moore
State: Oklahoma
ZIP Code: 73160-5856
Phone: (405) 735-7162

Authorized Official

Name: MRS. SELICA GRANDERSON
Title: DIRECTOR
Phone: (601) 331-4463

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X
Nutritionist - Nutrition, Education — Nutrition, Education	133NN1002X
Art Therapist	221700000X
Developmental Therapist	222Q00000X
Physical Therapist	225100000X
Recreation Therapist	225800000X
Music Therapist	225A00000X
Occupational Therapist	225X00000X
Speech-Language Pathologist	235Z00000X
Behavior Analyst	103K00000X	Primary

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