| Phobos Behavioral Of South Tulsa Llc | |
|
8242 S Harvard Ave Ste A Tulsa OK 74137-1648 | |
| (918) 392-3461 | |
| (918) 550-8228 |
| Full Name | Phobos Behavioral Of South Tulsa Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 8242 S Harvard Ave Ste A, Tulsa, Oklahoma |
| Authorized Official Name and Position | Anthony Tyler Owens (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5392404735 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phobos Behavioral Of South Tulsa Llc 8242 S Harvard Ave Ste A Tulsa OK 74137-1648 Ph: (918) 392-3461 | Phobos Behavioral Of South Tulsa Llc 8242 S Harvard Ave Ste A Tulsa OK 74137-1648 Ph: (918) 392-3461 |
| NPI Number | 1376311209 |
|---|---|
| Provider Enumeration Date | 12/20/2023 |
| Last Update Date | 12/20/2023 |
| Certification Date | 12/20/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376311209 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 106S00000X | Behavior Technician | (* (Not Available)) | Secondary |
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