| Pivotal Pathways Llc | |
|
19021 E Chokeberry St Owasso OK 74055-0037 | |
| (918) 972-1088 | |
| (918) 921-8143 |
| Full Name | Pivotal Pathways Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 19021 E Chokeberry St, Owasso, Oklahoma |
| Authorized Official Name and Position | Kathleen M Gary (OWNER) |
| Authorized Official Contact | 9189721088 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pivotal Pathways Llc Po Box 754 Owasso OK 74055-0754 Ph: (918) 972-1088 | Pivotal Pathways Llc 19021 E Chokeberry St Owasso OK 74055-0037 Ph: (918) 972-1088 |
| NPI Number | 1255053906 |
|---|---|
| Provider Enumeration Date | 09/19/2022 |
| Last Update Date | 09/29/2022 |
| Certification Date | 09/29/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255053906 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 163W00000X | Registered Nurse | (* (Not Available)) | Secondary |
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