| Extraordinary Minds Llc | |
|
2800 Nw 192nd St Apt 18301 Edmond OK 73012-9187 | |
| (918) 691-6042 | |
| Not Available |
| Full Name | Extraordinary Minds Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 2800 Nw 192nd St Apt 18301, Edmond, Oklahoma |
| Authorized Official Name and Position | Hagar Affify (CEO) |
| Authorized Official Contact | 9186916042 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Extraordinary Minds Llc 2800 Nw 192nd St Apt 18301 Edmond OK 73012-9187 Ph: (918) 691-6042 | Extraordinary Minds Llc 2800 Nw 192nd St Apt 18301 Edmond OK 73012-9187 Ph: (918) 691-6042 |
| NPI Number | 1669152278 |
|---|---|
| Provider Enumeration Date | 07/19/2023 |
| Last Update Date | 05/28/2024 |
| Certification Date | 05/28/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669152278 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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