Provider Demographics
NPI:1013633122
Name:OKFIRST, LLC
Entity type:Organization
Organization Name:OKFIRST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:MR
Authorized Official - First Name:TYSON
Authorized Official - Middle Name:K
Authorized Official - Last Name:WOLLERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-699-9347
Mailing Address - Street 1:17331 W 60TH ST S
Mailing Address - Street 2:
Mailing Address - City:SAND SPRINGS
Mailing Address - State:OK
Mailing Address - Zip Code:74063-2358
Mailing Address - Country:US
Mailing Address - Phone:918-699-9347
Mailing Address - Fax:
Practice Address - Street 1:17331 W 60TH ST S
Practice Address - Street 2:
Practice Address - City:SAND SPRINGS
Practice Address - State:OK
Practice Address - Zip Code:74063-2358
Practice Address - Country:US
Practice Address - Phone:918-699-9347
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OKFIRST,LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-10-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty