MEDICARE: SAVANNA ANDERSON

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	103K00000X	Behavior Analyst		OK

General Provider Information

NPI Number	:	1891335576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAVANNA ANDERSON

Provider Business Mailing Address
First Line	:	300 W 8TH ST
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73003-5707
Country	:	US
Telephone Number	:	405-570-6025
Fax Number	:

Provider Business Practice Location Address
First Line	:	425 S FRETZ AVE
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73003-5532
Country	:	US
Telephone Number	:	405-757-7980
Fax Number	:

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

Provider Enumeration Date	:	01/10/2020
Last Update Date	:	09/05/2025

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Directions to “ SAVANNA ANDERSON ” Practice Location

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