Mary Jordan Jarvis
Individual provider Active NPI Assistant Behavior Analyst · Lone Wolf, OK
NPI 1467904680 · NPPES record last updated Nov 4, 2016
Key facts
- NPI
- 1467904680
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Assistant Behavior Analyst 106E00000X
- Practice address
- 601 Day Ave
Lone Wolf, OK 73655-9779 - Phone
- (901) 318-8769
- NPI assigned
- Nov 4, 2016
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Assistant Behavior Analyst | 106E00000X | Yes |
Addresses
Primary practice location
601 Day Ave
Lone Wolf, OK 73655-9779
Mailing address
601 Day Ave
Lone Wolf, OK 73655-9779
Phone (901) 318-8769
Other names
- Mary Jordan Ruark
Other providers in Lone Wolf, OK
All providers in Lone Wolf, OK · Assistant 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 Nov 4, 2016. 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.