Healthcare Provider Details

I. General information

NPI: 1598601122
Provider Name (Legal Business Name): JOSCELYN MEZA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15201A CROWN AT LONE OAK RD
EDMOND OK
73013-2272
US

IV. Provider business mailing address

200 E GREEN ST
MEEKER OK
74855-9039
US

V. Phone/Fax

Practice location:
  • Phone: 405-849-4033
  • Fax:
Mailing address:
  • Phone: 405-788-8426
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: