State of Oklahoma

NPI #1790922185 in Tulsa, Oklahoma

Provider Information

NPI Number: 1790922185
Entity Type: Organization
Organization Name: State of Oklahoma
Primary Specialty: Behavior Analyst
Enumeration Date: Jan 7, 2009
Last Updated: Feb 1, 2011

Practice Location

Address: 2323 SOUTH HARVARD
City: Tulsa
State: Oklahoma
ZIP Code: 74114
Phone: (918) 293-2140

Authorized Official

Name: MR. WILFRED STEPHEN SAMPSON, MS
Title: CLINICAL BEHAVIORAL HEALTHCARE SPEC
Phone: (918) 293-2140

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Mental Illness	320800000X
Behavior Analyst	103K00000X	Primary

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