Mary Louise Baker

Individual provider Active NPI Behavior Technician · Midwest City, OK

NPI 1366219552 · NPPES record last updated Dec 27, 2023

Key facts

NPI
1366219552
Entity type
Individual (NPI type 1)
Primary specialty
Behavior Technician 106S00000X
Practice address
1717 S Air Depot Blvd
Midwest City, OK 73110-5103
Phone
(405) 622-4239
NPI assigned
Dec 7, 2023
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X Yes

Addresses

Primary practice location

1717 S Air Depot Blvd
Midwest City, OK 73110-5103

Mailing address

1717 S Air Depot Blvd
Midwest City, OK 73110-5103

Other providers in Midwest City, OK

All providers in Midwest City, OK · Behavior Technician in Oklahoma

Sources for this page

Verify at the official NPI Registry.