Provider Demographics
NPI:1831810365
Name:EISEL BEHAVIOR THERAPY AND CONSULTATION
Entity type:Organization
Organization Name:EISEL BEHAVIOR THERAPY AND CONSULTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:EISEL
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:405-605-9131
Mailing Address - Street 1:1110 W MAIN ST # 41
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-6923
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:829 NANCY LYNN TER
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-4223
Practice Address - Country:US
Practice Address - Phone:405-605-9131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-02
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health