Provider Demographics
NPI:1336520733
Name:PRICE, BETH J (MA, BCBA)
Entity Type:Individual
Prefix:MRS
First Name:BETH
Middle Name:J
Last Name:PRICE
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 REGAL RD
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-3438
Mailing Address - Country:US
Mailing Address - Phone:580-678-2138
Mailing Address - Fax:
Practice Address - Street 1:909 REGAL RD
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-3438
Practice Address - Country:US
Practice Address - Phone:580-678-2138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-11
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK0665667103TS0200X
OK1-14-9693103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool