| Alpha Autism Therapy, Llc | |
|
2524 N Broadway Suite 528 Edmond OK 73034 | |
| (405) 987-7354 | |
| (877) 349-8962 |
| Full Name | Alpha Autism Therapy, Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 2524 N Broadway, Edmond, Oklahoma |
| Authorized Official Name and Position | Katrina Gittins (CEO) |
| Authorized Official Contact | 4059877354 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alpha Autism Therapy, Llc 2524 N Broadway Suite 528 Edmond OK 73034 Ph: (405) 987-7354 | Alpha Autism Therapy, Llc 2524 N Broadway Suite 528 Edmond OK 73034 Ph: (405) 987-7354 |
| NPI Number | 1649917394 |
|---|---|
| Provider Enumeration Date | 05/15/2022 |
| Last Update Date | 06/18/2024 |
| Certification Date | 05/15/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649917394 | NPI | - | NPPES |
| 201077980A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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