MEDICARE: STEPHANIE F WARE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106E00000X	Assistant Behavior Analyst

General Provider Information

NPI Number	:	1538838982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE F WARE

Provider Business Mailing Address
First Line	:	5401 S SHERIDAN RD STE 104
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74145-7524
Country	:	US
Telephone Number	:	918-908-9353
Fax Number	:

Provider Business Practice Location Address
First Line	:	1316 N ALLEGHENY AVE
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74115-5302
Country	:	US
Telephone Number	:	918-816-6415
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2021
Last Update Date	:	09/09/2021

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Directions to “ STEPHANIE F WARE ” Practice Location

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