Healthcare Provider Details

I. General information

NPI: 1710842836
Provider Name (Legal Business Name): SEHOY SAMANTHA SEWELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2025
Last Update Date: 12/20/2025
Certification Date: 12/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 MEDICAL PKWY
CLAREMORE OK
74017-1088
US

IV. Provider business mailing address

2550 FREDERICK RD
CLAREMORE OK
74019-5507
US

V. Phone/Fax

Practice location:
  • Phone: 844-458-2100
  • Fax:
Mailing address:
  • Phone: 918-606-2331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: