Mardieth A Farrell
Individual provider Active NPI Behavior Technician · Antlers, OK
NPI 1508624693 · NPPES record last updated Mar 12, 2024
Key facts
- NPI
- 1508624693
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Technician 106S00000X
- Practice address
- 1402 W Main St
Antlers, OK 74523-2059 - Phone
- (580) 209-6112
- NPI assigned
- Mar 12, 2024
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brighter Days Wellness & Behavior Analysis Inc | Behavior Technician | Current |
Accepting new patients |
| Childrens Behavioral Centers LLP | Past | Accepting new patients |
Locations
1402 W Main St
Antlers, OK 74523
Phone (580) 209-6111
510 N High St
Antlers, OK 74523
Phone (580) 209-6112
17 S Central Ave
Idabel, OK 74745
Phone (580) 286-5184
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | Yes |
Addresses
Primary practice location
1402 W Main St
Antlers, OK 74523-2059
Mailing address
432057 State Highway 3
Fort Towson, OK 74735-7506
Phone (580) 372-6516
Other practice location 1
17 S Central Ave
Idabel, OK 74745-4625
Phone (580) 353-9726
Other providers in Antlers, OK
- Loretta Estep
- Ayesha K Factory
- Kamryn Fails
- Faith Medical Clinic
- Faith Medical Clinic LLC
- Katie Farrow
- Ashley Fines
- Gerald Wayne Flatt
- Britney Florez
- Micki Melinda Fouse
All providers in Antlers, OK · Behavior Technician in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 12, 2024. 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.