Provider Demographics
NPI:1811476328
Name:BUFFINGTON, ANDREA (BCBA)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:BUFFINGTON
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:HENRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4908 S SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74145-5712
Mailing Address - Country:US
Mailing Address - Phone:918-984-9153
Mailing Address - Fax:918-289-0579
Practice Address - Street 1:4908 S SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-5712
Practice Address - Country:US
Practice Address - Phone:918-984-9153
Practice Address - Fax:918-289-0579
Is Sole Proprietor?:No
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1-18-31155103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst