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NPI Code Detail

MEDICARE: KAILEY WHIBBEY

MEDICARE: KAILEY WHIBBEY
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
1106S00000XBehavior TechnicianOK

General Provider Information

NPI Number : 1942144365
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAILEY WHIBBEY
Provider Business Mailing Address
First Line : 11412 N 134TH EAST AVE STE C3
Second Line :
City : OWASSO
State : OK
Zip : 74055-4969
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11412 N 134TH EAST AVE STE C3
Second Line :
City : OWASSO
State : OK
Zip : 74055-4969
Country : US
Telephone Number : 918-376-3087
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2026
Last Update Date : 04/16/2026

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Directions to “ KAILEY WHIBBEY ” Practice Location

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