Provider Demographics
NPI:1417251547
Name:AUTISM BEHAVIOR CONSULTANTS OF OKLAHOMA, LTD
Entity Type:Organization
Organization Name:AUTISM BEHAVIOR CONSULTANTS OF OKLAHOMA, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIM
Authorized Official - Middle Name:
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:918-286-1261
Mailing Address - Street 1:2208 N YELLOWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-9102
Mailing Address - Country:US
Mailing Address - Phone:918-286-1261
Mailing Address - Fax:918-286-1265
Practice Address - Street 1:2208 N YELLOWOOD AVE
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-9102
Practice Address - Country:US
Practice Address - Phone:918-286-1261
Practice Address - Fax:918-286-1265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-04
Last Update Date:2011-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2756174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty