Tammy Sue Shirley, BACHELOR-BA
Individual provider Active NPI Behavior Analyst · Wynnewood, OK
NPI 1346579836 · NPPES record last updated Dec 14, 2009
Key facts
- NPI
- 1346579836
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- 103K0000X (OK)
- Practice address
- 406Westchickasawwynnewood,Oklahoma73098
202Southwashita
Wynnewood, OK 73098 - Phone
- (405) 665-2540
- Fax
- (405) 665-6396
- NPI assigned
- Dec 14, 2009
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 103K0000X | OK | MD | Behavioral Analyst |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 103K0000X | OK | Yes |
Addresses
Primary practice location
406Westchickasawwynnewood,Oklahoma73098
202Southwashita
Wynnewood, OK 73098
Mailing address
406Westchickasaw
202Southwashita
Wynnewood, OK 73098
Phone (405) 665-2540
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P5A4G5E4 | Medicaid | OK |
Other providers in Wynnewood, OK
- Dallas Rudd
- Dalton Bryant Rudd
- Teresa Gale Rue-Wallace
- Michelle Rue
- Rance Lane Rue
- Southern Oklahoma Eye Center, LLC
- Sphinx Diagnostics, LLC
- Delena J Sullivan
- Avis M Taylor
- Paige Juhree Theissen
All providers in Wynnewood, OK · Behavior Analyst in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 14, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.