Provider Demographics
NPI:1881042380
Name:KASIRI, HALLIE F (MA, BCABA)
Entity Type:Individual
Prefix:
First Name:HALLIE
Middle Name:F
Last Name:KASIRI
Suffix:
Gender:F
Credentials:MA, BCABA
Other - Prefix:MS
Other - First Name:HALLIE
Other - Middle Name:F
Other - Last Name:MCGRATH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1416 BRIGHTON AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-1406
Mailing Address - Country:US
Mailing Address - Phone:405-820-9981
Mailing Address - Fax:
Practice Address - Street 1:69 E SHORE DR
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:OK
Practice Address - Zip Code:73007-7103
Practice Address - Country:US
Practice Address - Phone:405-820-9981
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-25
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK0-16-7007103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst