Provider Demographics
NPI:1033760038
Name:HARTMAN, ROWLENA DUNCAN (BCBA, MED, BN, RN)
Entity Type:Individual
Prefix:
First Name:ROWLENA
Middle Name:DUNCAN
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:BCBA, MED, BN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 45
Mailing Address - Street 2:
Mailing Address - City:CONNERVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74836-0045
Mailing Address - Country:US
Mailing Address - Phone:580-221-0315
Mailing Address - Fax:
Practice Address - Street 1:91 BROADLAWN VILLAGE
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401
Practice Address - Country:US
Practice Address - Phone:580-221-0315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-23
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1626966106S00000X
OK12044379103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician