Healthcare Provider Details

I. General information

NPI: 1477482834
Provider Name (Legal Business Name): EVERBLOOM THERAPY & CO.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6115 SW 18TH ST
GUTHRIE OK
73044-7603
US

IV. Provider business mailing address

6115 SW 18TH ST
GUTHRIE OK
73044-7603
US

V. Phone/Fax

Practice location:
  • Phone: 580-273-5852
  • Fax:
Mailing address:
  • Phone: 580-273-5852
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: SARAH JEAN SAXON STAFFORD
Title or Position: CEO
Credential: M.A., BCBA-LBA
Phone: 580-273-5852