Spencer David Wideman

NPI #1962036251 in Tulsa, Oklahoma

Provider Information

NPI Number: 1962036251
Entity Type: Individual
Name: Spencer David Wideman
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Analyst
Enumeration Date: Feb 26, 2020
Last Updated: Feb 26, 2020

Practice Location

Address: 4908 S SHERIDAN RD
City: Tulsa
State: Oklahoma
ZIP Code: 74145-5712
Phone: (918) 984-9153

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Analyst	103K00000X	Primary

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